USP (797) Hand Hygiene Procedure: 1) Remove debris under fingernails with nail cleaner and warm water. 2) Wash hands and forearms to the elbow for at least 30 seconds with soap and water. Be vigorous and thorough. 3) Do not use antimicrobial scrub brushes on the skin because they can damage the skin and increase skin shedding. 4) Dry hands and forearms completely using lint-free disposable wipes or an electric hand dryer.