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HFAP surveyors will assess infection prevention and control practices when onsite at an ASC. This document is provided as a useful reference for ASC customers.

The Clean Hands Count campaign is a collaborative effort of the CDC, CMS, State Survey Agencies, and Accrediting Organizations, aiming to improve healthcare provider adherence to hand hygiene (HH) recommendations, address myths and misperceptions about alcohol-based hand rub (ABHR), and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands.

As a basic tenet of infection control and prevention, HFAP expects all accredited healthcare entities to have an infection control and prevention program that includes HH practices based on national standards or professional organizational guidelines. HH guidelines from the CDC and the World Health Organization (WHO) recommend the preferential use of ABHR over soap and water in most clinical situations.1,2

When hands are not visibly soiled and the facility is not experiencing an outbreak of norovirus or C. diff, ABHR is the preferred method of HH for healthcare personnel to clean their hands because it:1

  • Is more effective at killing potentially deadly germs on hands than soap.
  • Requires less time.
  • Is more accessible than hand washing sinks.
  • Produces reduced bacterial counts on hands.
  • Improves skin condition with less irritation and dryness than soap and water.

During surveys, surveyors observe healthcare staff HH practices and use of ABHR.  Please be aware that they may :

  • Observe HH practices.
  • Review HH procedures (CDC and WHO recommend procedures promoting the   preferential use of ABHR).
  • Observe whether ABHR is readily available for staff to use to support effective HH.
  • Document non-compliance related to infection control and prevention, including HH.

HH compliance makes a difference in reducing healthcare associated infections. This combined effort of CMS, AOs and SSAs reinforces the need for effective HH and the importance of access to and use of ABHR as the preferred method of HH for healthcare personnel.

Footnotes and additional links

  1. Centers for Disease Control and Prevention (CDC). Hand Hygiene in Healthcare Settings
  2. World Health Organization. WHO guidelines on hand hygiene in health care.


The main CDC page for coronavirus information can be found here. Additional and more focused links are identified below. Please refer to News on the homepage for additional items which can be filtered by program type or topic tag.

General Guidance

Disinfectants to control COVID-19 (from EPA)

Guidance on workplace preparedness (from OSHA)

Healthcare Guidance

General information:

Coronavirus stability on surfaces (from NIH – study to establish how long the virus remains on cardboard, copper, plastic, and stainless steel surfaces)

COVID-19 resource page (from ASHE–American Society for Health Care Engineering– some content is members-only, but much is available to all)


Hand hygiene FAQs (from CDC – addresses best method, alternative to ABHR, shortage of ABHR)

Interim IPC recommendations for patients with suspected or confirmed COVID-19 (from CDC)

PPE (esp. medical glove) conservation strategies letter (from FDA – strategies are categorized for a range of needs and supply levels and are intended to assist health care organizations as they determine procedures during the COVID-19 pandemic)

PPE FAQs (from CDC – covers issues of transporting patients within the facility, asymptomatic exposed patients, EVS)


Strategies for optimizing the supply of N95 respirators (from CDC)

Guidance for use of certain industrial respirators by health care personnel (from CMS)

For hospitals


Emergency Management Compliance (HFAP recommendations)

EMTALA requirements and implications related to COVID-19 (from CMS)

Patient triage, Placement and Discharge (from CMS QSO memo)

For laboratories

CLIA FAQ for laboratories performing COVID-19 patient testing (from CMS)

Biosafety FAQ (from CDC)

Emergency use authorizations (from FDA: This link includes a list of all EUAs. Refer to this News item for a summary related to recently identified tests.)

For compounding pharmacies 

Compounding alcohol-based hand sanitizer during COVID-19 pandemic  (from USP: This document is for informational purposes only and is intended to address shortages of alcohol-based hand sanitizers associated with the COVID-19 pandemic.)

USP response to shortages of garb and PPE for sterile compounding during COVID-19 pandemic  (from USP: This document is for informational purposes only and is intended to address the garb and personal protective equipment (PPE) shortages caused by the COVID-19 pandemic.)

For dialysis centers

ICP concerning COVID-19 in dialysis facilities (from CMS)