A LITTLE LIGHTBULB MOMENT
Safety, infection prevention and clinical judgment
Clean hands beat hidden hitchhikers
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Soap or sanitizer breaks the contamination commute
The idea behind the cue
Hand hygiene is the single most important routine measure to reduce pathogen spread. Use alcohol-based hand rub for routine decontamination when hands are not visibly soiled; use soap and water when hands are visibly dirty, after toilet use, and for some organisms such as spore-formers that alcohol does not reliably remove. Hand hygiene is indicated before and after patient contact and after contact with potentially contaminated surfaces.
Practice this flashcard →Make it memorable
Short & simple
Soap or sanitizer breaks the contamination commute
Acronym
RSST — Rowdy Sloths Steal Tacos.
Story
A glittery goblin hops from a door handle to a lunch tray until a quick hand rub wipes its tiny suitcase away. The goblin can’t ride if hands are cleaned at the right times.
Connect the pieces
- R (Rowdy) → Routine: Use alcohol-based hand rub for routine decontamination when hands are not visibly soiled.
- S (Sloths) → Soil: Use soap and water when hands are visibly dirty or after toilet use.
- S (Steal) → Spores: Alcohol does not reliably remove some spore-formers, so soap and water is preferred.
- T (Tacos) → Timing: Hand hygiene is needed before and after patient contact and after touching potentially contaminated surfaces.
- Rowdy · Routine: Use alcohol-based hand rub for routine decontamination when hands are not visibly soiled.
- Sloths · Soil: Use soap and water when hands are visibly dirty or after toilet use.
- Steal · Spores: Alcohol does not reliably remove some spore-formers, so soap and water is preferred.
- Tacos · Timing: Hand hygiene is needed before and after patient contact and after touching potentially contaminated surfaces.
Know the limits
Alcohol rub is less reliable on visible soil and does not reliably eliminate some spores; soap and water is preferred in those situations.
Further reading · OpenStax nursing textbooks ↗Check your understanding
Which action best reduces transmission of organisms between routine care contacts?
A. Use a face shield instead of cleaning hands
B. Perform hand hygiene at the indicated times
C. Wear sterile gloves for every interaction
D. Spray the room with disinfectant between every task
Reveal explanation
Perform hand hygiene at the indicated times
Hand hygiene is the core routine practice that interrupts spread of microorganisms. Gloves, eye protection, and environmental cleaning are useful in specific situations but do not replace cleaning hands.