The self-directed rubbing method This is a method for hygienic hand disinfection. Unlike the classic 6-step method according to the EN 1500 standard, it does not rely on a rigidly prescribed sequence of movements. Instead, the focus is on completely wetting the entire skin surface of the hands with the disinfectant.

Principle of personal responsibility

„"Personal responsibility" means that users consciously perform hand disinfection and actively monitor the result. The crucial factor is not simply completing individual movements, but ensuring the hands are completely covered.

• Objective: The primary goal is to avoid gaps in coverage and to achieve reliable germ reduction.
• Individual design: Since rigid movement sequences are often prone to errors in practice, this method leaves the exact execution of the movement to the user.
• Special focus: Main contact points and areas with frequent gaps in coverage must be rubbed in particularly intensively.

Implementation and success factors

The self-administered hand-rubbing method focuses on complete coverage. The technique is chosen so that both hands remain fully coated with hand sanitizer for the specified contact time.^{1 2}

• Dry hands: The hand sanitizer should be applied to dry hands so that it is not diluted by water.
• Sufficient quantity: At least 3 ml of hand sanitizer are used. A practical guideline is the amount that fits in the palm of your hand.
• Complete wetting: The product is applied in such a way that it reaches fingertips, nail folds, thumbs, spaces between fingers, palms, backs of hands and wrists.
• Critical areas: Areas where gaps in coverage frequently occur are rubbed in particularly intensively (e.g., fingertips, nail folds, and thumbs).
• Exposure time: The contact time specified by the manufacturer is observed. Hands must remain moist during this time.
• Diploma: After the application time has elapsed, the hands are not dried. The product dries in the air.

Differentiation from the 6-step method

The classic 6-step method is based on a fixed sequence of movements. It originates from the Test method according to EN 1500 well-known and can be helpful for training.

However, the Clean Hands campaign points out that DIN EN 1500 is a testing method for hand disinfectants and not a binding guideline for the rubbing technique in everyday life.³ According to this classification, a fixed sequence of movements does not automatically guarantee the reliable avoidance of wetting gaps.

Study situation

A frequently cited study by Kampf et al. In 2008, a study compared various hand-rubbing techniques using fluorescent dye and UV light. The "responsible application," meaning self-directed application without a fixed sequence of steps, achieved at least comparable hand coverage to the classic six-step technique. The authors concluded that high-quality hand disinfection requires 30 seconds and that self-directed or adapted techniques can be practical.⁴

Another study by Sakmen et al. A 2019 study examined medical students and compared the 6-step method with self-administered hand disinfection. No significant differences were found immediately after the training. However, at later measurement points, the self-administered method performed better in some areas, particularly regarding the distribution of disinfectant on the hands.⁵

Recommendations

The Clean Hands Campaign The classic 6-step method is explicitly classified as a testing method according to DIN EN 1500 and not as a binding guideline for practical application techniques in everyday life. According to the position paper, a fixed sequence of movements does not automatically guarantee that gaps in coverage are reliably avoided. Therefore, training, sufficient product quantity, complete application, and particular attention to areas prone to gaps in coverage are especially recommended.⁶

The S2k guideline „The "Hand Disinfection and Hand Hygiene" guideline of the Association of Scientific Medical Societies (AWMF) supports this approach. No advantage has been demonstrated for the movement sequence according to DIN EN 1500 compared to a self-chosen rubbing technique.⁷

Importance for education and training

The shift to self-directed hand-rubbing requires a change in training practices in the healthcare sector, moving the focus from rigid sequences of movements to problem awareness and the actual protective effect. Modern training approaches concentrate on developing an awareness of critical areas, the correct amount of disinfectant, and its required holding time, thereby increasing staff acceptance and compliance.

Visual feedback is particularly helpful because gaps in coverage become immediately visible. This allows you to check whether your personal application sequence is working reliably and whether all relevant skin areas are being reached.

Technical recommendations from KRINKO/RKI, WHO and the Clean Hands Campaign support this focus on complete wetting and practical training.

Sources:

1. Clean Hands Campaign, Scientific Advisory Board: Position paper „Rubbing Method“. Adopted version of September 30, 2011. Accessed June 11, 2026.
   https://www.aktion-sauberehaende.de/files/public/fileadmin/ash/download-Material/Positionspapiere-Literatur/03-ASH_Positionspapier_Einreibemethode_30092011.pdf ↩︎
2. German Society for Hospital Hygiene (DGKH): S2k Guideline „Hand Disinfection and Hand Hygiene“. AWMF Registry No. 075-004, Version 4.0, Status: February 3, 2023. Accessed on June 11, 2026.
   https://register.awmf.org/assets/guidelines/075-004l_S2k_Haendedesinfektion-und-Haendehygiene_2023-09.pdf
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3. Clean Hands Campaign, Scientific Advisory Board: Position paper „Rubbing Method“. Adopted version of September 30, 2011. Accessed June 11, 2026.
   https://www.aktion-sauberehaende.de/files/public/fileadmin/ash/download-Material/Positionspapiere-Literatur/03-ASH_Positionspapier_Einreibemethode_30092011.pdf ↩︎
4. 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 Infectious Diseases. 2008;8:149. DOI: 10.1186/1471-2334-8-149.
   https://pubmed.ncbi.nlm.nih.gov/18959788/ ↩︎
5. Sakmen KD, Sterz J, Stefanescu MC, Zabel J, Lehmann M, Ruesseler M: Impact of the teaching method of the rub-in technique for learning hygienic hand disinfection in medical studies: a comparative effectiveness analysis of two techniques. GMS Hygiene and Infection Control. 2019;14. DOI: 10.3205/dgkh000332.
   https://pubmed.ncbi.nlm.nih.gov/31815090/ ↩︎
6. Clean Hands Campaign, Scientific Advisory Board: Position paper „Rubbing Method“. Adopted version of September 30, 2011. Accessed June 11, 2026.
   https://www.aktion-sauberehaende.de/files/public/fileadmin/ash/download-Material/Positionspapiere-Literatur/03-ASH_Positionspapier_Einreibemethode_30092011.pdf ↩︎
7. German Society for Hospital Hygiene (DGKH): S2k Guideline „Hand Disinfection and Hand Hygiene“. AWMF Registry No. 075-004, Version 4.0, Status: February 3, 2023. Accessed on June 11, 2026.
   https://register.awmf.org/assets/guidelines/075-004l_S2k_Haendedesinfektion-und-Haendehygiene_2023-09.pdf
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