A nurse is caring for a group of clients and performs hand hygiene. In which of the following situations is it appropriate for the nurse to use soap and water instead of an alcohol-based hand rub?

A. C. difficile forms spores that are resistant to alcohol-based hand sanitizers. Proper handwashing with soap and water physically removes the spores and reduces the risk of transmission. This is a standard infection prevention practice in healthcare settings. B. While hand hygiene is critical before caring for immunocompromised clients, an alcohol-based hand rub is generally sufficient unless the hands are visibly soiled. Soap and water is not required in this situation unless contamination is visible or exposure to spore-forming organisms has occurred. C. In most routine care activities, including vital signs collection, alcohol-based hand rub is appropriate and effective unless hands are visibly dirty or contact with spore-forming pathogens has occurred. Soap and water is not mandatory in this scenario.