Question

Alcohol-based hand rubs provide effective hand hygiene in most circumstances, but should not be used when:

1. the hands are contaminated with visible soil.
2. the hands are contaminated with blood or body secretions.
3. the hands may be contaminated with endospores.
4. removing protective gloves.

Answer 1

Alcohol-based hand rubs should not be used when hands are visibly dirty, contaminated with blood or body fluids, possibly contaminated with endospores, or immediately after removing protective gloves. Instead, handwashing with soap and water is recommended in these circumstances to effectively remove microorganisms.

Step-by-step explanation:

Alcohol-based hand rubs and sanitizers are highly effective in many circumstances due to their ability to denature proteins and disrupt microbial cell membranes. They are particularly effective against bactericidal, fungicidal, and viricidal for enveloped viruses. However, they should not be used in certain circumstances:

1. When hands are visibly dirty or contaminated with organic material. The presence of soil or organic matter can inactivate the alcohol and render it ineffective.
2. When hands are contaminated with blood or bodily fluids. The alcohol may not be able to penetrate the fluid to reach and kill the underlying pathogens.
3. If hands may be contaminated with spores, such as Clostridium difficile, since alcohol-based hand rubs are not sporicidal.
4. Immediately after removing protective gloves when there could still be contaminants on the hands that need to be physically removed by washing.

For effective hand hygiene, the Center for Disease Control and Prevention recommends washing hands thoroughly with soap and water when they are visibly dirty, before eating, and after using the restroom. This method is able to remove dirt, bacteria, and viruses, including those that may be resistant to sanitizers.