Which sequence best reflects proper hand hygiene steps?

• A. Roll sleeves and rinse hands up to wrist; Lathers all surfaces for 20 seconds; Rinse surfaces keeping hands high.
• B. Roll sleeves; Rinse hands up to wrist; Lathers all surfaces for 20 seconds; Rinse all surfaces keeping hands low.
• C. Rinse hands first, then soap, then dry.
• D. Wash with hot water only.

Answer: (B)

Hand hygiene relies on using soap with thorough friction for a full 20 seconds, while keeping sleeves out of the water and directing rinse in a way that minimizes recontamination. Rolling the sleeves protects clothing from contact with contaminated water. Starting with a rinse up to the wrists sets the skin to receive soap and helps wet all surfaces evenly. Then thoroughly lather all surfaces for at least 20 seconds, making sure to cover palms, backs of hands, between fingers, and under nails. Finally, rinse all surfaces with the water flowing in a direction that keeps the hands lower than the forearms to prevent dirty water from running back onto the skin. Other sequences skip the soap or the 20-second scrub, reverse the rinse/soap order, or imply ineffective or unsafe water use, which is why this option best reflects proper technique.