The correct one Instructions for hand disinfection It forms the foundation of infection prevention. The aim of hygienic hand disinfection is to eliminate transient (temporarily adhering) Germ flora to reduce it to such an extent that there is no longer any risk of infection from the hands.

In practice, the 6-step method called EN 1500, while modern approaches increasingly focus on a independent rubbing technique place.

Preparation: Basis for effective disinfection

Before starting hand disinfection, the following conditions must be ensured:

• Unadorned: Since germs can survive protected under jewelry and fingernails, hands and forearms should be free of rings, watches, and bracelets. Fingernails should be as short and unpainted as possible.
• Dry hands: The disinfectant should only be applied to dry skin. Moisture leads to dilution effects and can promote skin irritation.
• Contactless operation: To avoid cross-contamination, the dispenser should ideally be operated with the elbow.

Procedure: Quantity & Rubbing technique

• Crowd: There must be a sufficient Dosage amount Hand sanitizer (approx. 3-5 ml depending on hand size) should be taken so that all wetted skin areas remain continuously moist for the contact time declared by the manufacturer (usually 30 seconds).
• Rubbing technique: The rubbing technique should ensure that all areas of the hands and wrists are completely wetted and remain moist for the duration of the application time.

The classic method: 6 steps

The widely used instructions are based on six steps from the EN 1500 test method, each of which is repeated approximately 5 times.

1. Palm to palm.
2. Right palm over left back of hand and vice versa.
3. Palm to palm with fingers spread.
4. Outside of the interlocked fingers into the opposite palm.
5. Rubbing the thumbs into the closed palm of the hand.
6. Rub closed fingertips in a circular motion in the palm of the hand.

This well-known method systematically considers the essential areas of the hands and can therefore help to clearly demonstrate the hand-rubbing technique. However, EN 1500 was primarily developed as a standardized testing method for hygienic hand disinfectants. It should therefore not automatically be understood as a binding guideline for daily use. In addition to the classic 6-step method, the focus today is increasingly shifting to self-directed hand-rubbing techniques.

The modern method: Focus on the result

Modern infection prevention now frequently recommends the self-directed rubbing method. The focus is not on a fixed sequence of individual movements – what is crucial is that users consciously pay attention to the result.

Studies on the rubbing technique¹ and the professional classification of the Clean Hands campaign² This shows that a rigid sequence of steps does not automatically lead to better results in practice. The AWMF S2k guideline "Hand Disinfection and Hand Hygiene" also demonstrates this.„³ emphasizes that complete wetting of the hands during the application time is crucial for effectiveness.

The advantage: Instead of following a rigid choreography (focus on the sequence of movements), the focus is specifically on a strategy for complete wetting of all skin surfaces (focus on the result), thus promoting one's own motivation during application.

Key principles according to the S2k guideline:

1. Use a sufficient amount: At least 3 ml of disinfectant solution should be applied to ensure adequate wetting.
2. Ensure complete wetting: The solution should be evenly distributed when rubbing it into the hands, so that the entire surface of the hands (fingertips, nail folds, thumbs, spaces between fingers, inner and outer surfaces and wrists) is completely wetted.
3. Specifically include critical areas: Particularly critical and often forgotten areas, such as nail folds, fingertips and thumbs, should be treated consciously and intensively.
4. Keep moist until the end of the exposure time: Hands should remain moist for the contact time specified by the manufacturer. A minimum contact time of 15 seconds should be observed. If they become dry before the end of the contact time, more disinfectant should be applied. Hands should not be dried after the contact time has elapsed.

The optimal order: Prioritizing the „hotspots“

To maximize safety, it is recommended to first rub the fresh disinfectant into areas with the highest germ density and where sufficient liquid is needed to penetrate deep into hard-to-disinfect areas. Sequence of hand disinfection serves as a strategy to achieve optimal germ reduction:

• Fingertips and nail folds first: The fingertips of both hands are dipped directly into the palm filled with disinfectant and rubbed in using a circular motion. Since this is where most germs reside, this method ensures optimal contact time and even distribution of the disinfectant.
• Thumb and spaces between fingers: These areas are most often missed with the standard method. They are specifically and thoroughly moistened in the second step.
• Palms and backs of hands: Then the disinfectant is spread liberally over the palms and backs of the hands.
• Wrists: Finally, the disinfection is extended to the wrists.

Important: If hands become dry before the 30 seconds are up, more disinfectant must be applied immediately. Only complete coverage guarantees full effectiveness.

Methodological support through training

Practical training methods support the correct application of hand disinfection by enabling immediate visual verification of success. Methods such as DesiCoach® or UV control make visible how completely the disinfectant has been distributed on the skin.

This feedback helps to confidently master the self-administered hand-rubbing technique and to establish hand disinfection as a conscious act of infection prevention.

Functions of feedback using the DesiCoach® method:

1. Dose validation: In the first part of the training with the dye, it becomes apparent whether the chosen dosage is sufficient to completely wet the individual skin surface.
2. Technical monitoring & optimization: Gaps in wetting become visible in the first part of the training and can then be specifically corrected in the second part of the training using the color remover.
3. Sequence reflection: Color residues after bleaching indicate whether the individually chosen sequence was suitable for completely covering even critical and hard-to-reach skin areas, such as nail folds, with sufficient disinfectant solution.
4. Avoiding dripping: Drip residue is consciously perceived during training and helps to develop a rubbing technique in which the liquid is distributed in a more controlled manner.

Sources:

1. Kampf G, Reichel M, Feil Y, Eggerstedt S, Kaulfers PM. Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection. BMC Infect Dis. 2008 Oct 29;8:149. doi: 10.1186/1471-2334-8-149. PMID: 18959788; PMCID: PMC2600642. ↩︎
2. Clean Hands Campaign, Scientific Advisory Board. Position Paper: Rubbing Method. Adopted version of 2011-09-30. Accessed on 2026-06-11. ↩︎
3. German Society for Hospital Hygiene. S2k Guideline Hand Disinfection and Hand Hygiene. AWMF Registry No. 075-004, Version 4.0, Status: 2023-02-03. Accessed on 2026-06-11. ↩︎