Tips for Good Handwashing in a Nursing Home Setting

Nursing home worker washing her hands

Good handwashing in a nursing home setting by caregivers, patients and visitors can be a major protection against the spread of infectious diseases.

Infections are the Enemy

The United States Centers for Disease Control (CDC) reports that:

  • Infection is the #1 cause of death among nursing home residents.
  • Infection is the most frequent reason for a person to be moved from a nursing home to a hospital for care.
  • Every patient in a nursing home gets an average of one infection each year.

Infections such as the common cold, flu and diarrhea can quickly spread through hand-to-hand contact in a nursing or convalescent home. Any of these conditions are uncomfortable; but, they can be very serious in older adults. A cold, or the flu, can quickly turn into pneumonia. The Mayo Clinic reports that the combination of flu and pneumonia is the seventh leading cause of death among older Americans.

Handwashing Fights Infections

Handwashing is the most effective way to avoid spreading diseases. Clean hands can minimize the transmission of microorganisms to an elderly person whose immune system is already compromised because of their age and health issues. To get your hands really clean, you need to either use an alcohol-based sanitizer or soap and water.

Wearing gloves is not enough to fight infections. Caregivers wearing gloves can still transmit infections if:

  • They don't change gloves after working with a patient.
  • They wear a glove that is cut, torn or has a tiny hole from a needle prick or a manufacturing defect.

Good Handwashing in a Nursing Home Setting

Caregivers, patients and visitors need to practice frequent and thorough handwashing to fight infections.


The World Health Organization instructs that hands should be washed throughout the caregiver's shift, including:

  • As soon as they come to work
  • Before they go into a patient's room
  • When they are leaving a patient's room
  • Before and after each task they perform
  • Before and after they touch a person
  • Before and after they put on gloves
  • Before they leave a rest room
  • Before taking a break
  • Before and after they eat or handle food
  • After they cough or sneeze or blow their nose
  • After handling garbage or trash
  • Before leaving work


Visitors should wash their hands:

  • Before they enter a nursing home
  • Before and after having contact with a patient
  • Before they leave a rest room
  • After touching anything in the patient's room
  • When leaving the nursing home facility

Soap versus Alcohol-based Sanitizers

Up until the mid 1990s, soap was the primary cleansing agent for handwashing. The introduction of alcohol-based sanitizers such as Purell provided another alternative. These products are now considered as effective as soap and water at stopping the spread of infection.

Alcohol-based Sanitizers

Alcohol-based sanitizers are excellent at killing bacteria and viruses. They also can help prevent skin dryness due to anti-drying ingredients which are added to the formula.

To use these sanitizers effectively:

  • Apply about a ½-teaspoon of the product into the palm of your hand.
  • Rub your hands together until they are dry. Be sure to cover all surfaces of your hands with the product.

Soap and Water

The key to effective handwashing with soap and water is taking enough time to scrub and then rinsing your entire hands and wrists to remove the microorganisms:

  1. Turn on the water and keep it running while you wash your hands.
  2. Hold your hands under a water stream until they are wet up to the wrists.
  3. Apply a generous amount of soap in your palm.
  4. Rub your hands together to create soap foam.
  5. Wash your hands for at least 15 seconds, being sure to wash the front and back of the hands, between the fingers, around and under the finger nails and up your arm about eight inches above your wrist.
  6. Do not touch the sink while washing.
  7. Rinse your hands without touching the sink, keeping your hands lower than your wrist.
  8. Dry your hands with a paper towel.
  9. Use the paper towel to turn the water off.
  10. Dispose of the paper towel.


Good handwashing in a nursing home setting by care givers, patients and visitors is necessary to minimize the transmission of viruses and bacteria. Careful cleansing with an alcohol-based cleanser can be just as effective as a thorough soap and water cleansing.

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Tips for Good Handwashing in a Nursing Home Setting