3. Hand hygiene, PPE and dirty-to-clean workflow
Hand hygiene
Alcohol gel is appropriate on visibly clean hands. Wash with soap and water when hands are visibly soiled, after using the toilet, and after contact with blood or body fluids. Dry thoroughly. Bare below the elbows: short sleeves, no wrist jewellery, short clean nails. Cover cuts with a waterproof dressing.
When to clean hands
- Before touching a patient or their clean clinical zone
- Before a clean or aseptic task (for example opening a sterile pouch)
- After body fluid exposure risk
- After touching a patient or the surroundings
- After removing gloves
PPE — choose for the task
| Task | Typical PPE |
|---|---|
| Clinical treatment with splash or aerosol risk | Gloves, fluid-resistant mask, eye protection; apron or gown as indicated |
| Manual cleaning of dirty instruments | Household or heavy-duty gloves, apron, eye protection, mask |
| Handling sterile packs | Clean hands; do not use the same gloves that handled dirty trays |
Don PPE before dirty work. Remove it so contaminated surfaces do not touch your face or clothing. Always clean hands after removal. Never wash or gel gloves and reuse them between patients. Prescription glasses are not protective eyewear unless they have side protection designed for splash.
One-way flow
Dirty instruments should never cross the path of clean or sterile ones. In a dedicated decontamination room this is a physical dirty zone and a clean zone. In a smaller setting you still need a defined dirty-to-clean sequence and enough space that trays are not stacked on sterile packs.
Transport and holding
Move dirty instruments in a rigid, leak-proof, lidded container, labelled as contaminated. If they cannot be cleaned immediately, keep them moist with a holding gel or covered system the IFU allows. Dried blood is much harder to remove.
What never happens in a safe flow
- Opening a sterile pouch on a dirty worktop
- Using a “quick wipe” as a substitute for the validated instrument cycle
- Staff in dirty PPE walking into the clean store