Which sequence of hand hygiene steps is correct?

• A. Apply soap, wet hands, scrub for 20 seconds, rinse, dry with a towel.
• B. Wet hands, apply soap, scrub for 10 seconds, rinse, dry with towel.
• C. Wet hands, apply soap, scrub for 60 seconds, rinse, dry with towel.
• D. Wet hands, apply soap, scrub for at least 20 seconds, rinse, dry with a clean towel, and avoid recontamination.

Answer: (D)

Proper hand hygiene requires washing steps in the right order and for enough time to remove germs effectively. Wet your hands, apply soap, and scrub for at least 20 seconds to lift microbes from all surfaces of the hands. Rinse thoroughly to wash away the loosened germs. Dry the hands with a clean towel to prevent moisture that can harbor microbes, and use that towel to turn off the faucet to avoid recontaminating the hands. This sequence—wet, soap, scrub for at least 20 seconds, rinse, dry with a clean towel, and avoid recontamination—fits best practice because it combines correct timing with measures to prevent recontaminating clean hands. Other options fall short either by scrubbing for too short or too long a time, or by omitting the step that prevents recontamination during drying and faucet use.