How to Use an Alcohol-Based Hand Rub (ABHR)



How to use a waterless, alcohol-based hand rub.

Please Note: Alcohol-Based Hand Rub (ABHR) is only to be used for hand hygiene - if hands are visibly soiled they must be washed.

Recommendations for routine hand hygiene technique vary according to the formulation being used, with major differences between alcohol-based hand rub, foam hand rubbing, and soap and water.

Surgical hand hygiene technique is a different technique again, and we will look at this in the next section.

Regardless of which formula is being used the manufacturer’s instructions for use must always be followed, otherwise, you cannot guarantee your hand hygiene will be effective.

Waterless hand hygiene. When waterless hand hygiene solutions are being used it is important that enough solution is applied to cover the entire palm. The number of applications needed to ensure the correct amount varies according to the volume dispensed with each dose and the size of the user’s hand. Once sufficient product has been applied, users should rub their hands together ensuring all surfaces of the hands and fingers are covered. This procedure takes between 20 to 30 seconds to complete. Rubbing should be performed until the hands are dry. (Detailed illustrations of this technique are available in the WHO Guidelines on Hand Hygiene.)

Rub your hands together to cover your entire palms. Don’t forget the sides of your hands, as well. Place your left hand over the back of your right hand and interlace your fingers, and rub clean, trying to clean right between your fingers, and in all the cracks and crevices, and up and down the inside of your fingers. As well, you are aiming to thoroughly clean the back of your hand.

Then, place your right hand over the back of your left hand and repeat this procedure.

Now reverse and do the insides. Place your palms together, interlace your fingers, and clean both your palms and between your fingers from the inside. You’re trying to get right in the cracks and crevices between your fingers as well as ensuring your palms are well cleaned.

Now, lock your hands together using your fingers to ensure your palms are opposite each other. Clean the ends of your fingers and nails really well, making sure the fluid reaches into the crevices.

Now for your thumbs. Grasp your thumb with the forefingers of the opposite hand and clean the thumb you have grabbed really well in a twisting motion, then do the same on the other hand. You need to completely clean all surfaces of your thumb down to and including your wrist.

Once you have done that and you feel as f you are really getting your hands clean, you now need to rub in a circular manner with your clasped fingers, into the palm of your hand. Make sure you do this with both of your hands. Clean fingers are essential for hand hygiene.

When your hands are dry of all alcohol-based hand rub, and you are satisfied you have completed the hand rub correctly, your hands should be safe.

Learn more about hand hygiene here:

Part of a complete learning course on hand hygiene, written by Cathryn Murphy RN, PhD. Complete the full module with an Ausmed subscription now, visit
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First Published10 March 2020
Updated10 March 2020
30 March 2025
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Infectious Diseases
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