When should you perform hand hygiene with soap and water vs an alcohol-based hand rub?

• A. Wash with soap and water when hands are visibly dirty; use an alcohol-based rub for routine decontamination when hands are not soiled.
• B. Soap and water always; alcohol rub never.
• C. Alcohol-based rub for visibly dirty hands; soap and water for routine cleaning when not soiled.
• D. Wash with soap and water when hands are visibly dirty or when exposure to spores is possible; use alcohol-based rub for routine decontamination when hands are not visibly soiled.

Answer: (D)