A nurse is teaching a group of assistive personnel about performing hand hygiene when caring for a client who has an immunodeficiency disorder. Which of the following information should the nurse include in the teaching?

A. Dry hands by starting from the wrist and moving toward the fingers: Proper hand drying should begin at the fingertips and move toward the wrist to prevent recontamination of the cleaned areas. Starting at the wrist could transfer microorganisms back toward the fingers. B. Lather hands with soap and apply friction under running water for 5 seconds: Effective handwashing requires at least 20 seconds of friction with soap and water to remove microorganisms. Five seconds is insufficient to achieve proper decontamination, especially when caring for immunocompromised clients. C. Decontaminate hands with an alcohol-based hand rub after taking the client's pulse: Using an alcohol-based hand rub after brief, low-risk contact, such as taking a pulse, is appropriate for routine hand hygiene. It is an effective, quick method to reduce microbial load without the need for soap and water. D. Wash hands with an alcohol-based hand rub if you have artificial nails: Artificial nails can harbor microorganisms and are not a contraindication for alcohol-based hand rubs alone. Proper handwashing with soap and water is preferred when hands are visibly soiled or when caring for high-risk clients.