Refers to hand washing with soap and water or hand sanitizing with alcoholic solutions, gels or tissues to maintain clean hands and fingernails. It should be performed frequently with soap and water for at least 15-20 seconds:

• Before and after preparing food;
• Before and after eating;
• After using the toilet;
• After coughing/sneezing into a tissue (or if non compliant with respiratory etiquette);
• Before and after using a surgical/procedure mask and after removing gloves;
• After handling body fluid-contaminated waste or laundry;
• Whenever hands look dirty.

If soap and water are not available, hands can be cleaned with an alcohol-based hand sanitizer (ABHS) that contains at least 60% alcohol, ensuring that all surfaces of the hands are covered (e.g. front and back of hands as well as between fingers) and rubbed together until they feel dry. For visibly soiled hands, soiling should be removed with an alcohol-based hand wipe first, followed by use of ABHS.

Touching one's eyes, nose, and mouth with unwashed hands should be avoided.