Conclusion
Evidence-based hand hygiene can prevent transmission of the most important nosocomial pathogens and also keep employees' skin healthy. In most clinical situations hygienic disinfection is indicated for hand decontamination on grounds of better efficacy and -cutaneous tolerance. Washing with soap and water is necessary only when the hands are visibly soiled, or following disinfection in the case of contamination by spores of bacteria such as C. difficile. Compliance could be improved by knowledge of the principal clinical circumstances in which hand disinfection by healthcare workers genuinely benefits the patient.