How do pharmacy technicians prevent infection and contamination?
PTCB topic: Infection prevention and cleaning
- Use alcohol sanitizer (at least 60% alcohol) for most hand hygiene.
- Soap and water: visibly soiled hands, or C. difficile or norovirus outbreaks.
- Clean your hands right after removing gloves.
- PPE goes on gown first, gloves last; the mask comes off last.
- Count hazardous drugs only on their own labeled tray.
Key facts
- CDC prefers alcohol-based hand sanitizer with at least 60% alcohol unless hands are visibly soiled.
- Soap and water is used for visibly soiled hands and when caring for patients during C. difficile or norovirus outbreaks.
- Gloves are not a substitute for hand hygiene; clean hands immediately after removing gloves.
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- Putting PPE on: gown, mask or respirator, goggles or face shield, then gloves.
- Taking PPE off: gloves (or gown and gloves) first and the mask or respirator last, then hand hygiene.
- Counting trays and counters are cleaned on a regular schedule and also whenever they are visibly soiled.
- Hazardous drugs are counted on a separate, labeled tray used only for hazardous drugs.
Quick check1 question · 2 more at the end
According to CDC hand hygiene guidance for health care workers, when should a pharmacy technician wash with soap and water instead of using alcohol-based hand sanitizer?
Correct answer: B.
CDC prefers alcohol-based hand sanitizer for most clinical hand hygiene because it works well and is quick. Soap and water is used when hands are visibly soiled, and during outbreaks of C. difficile or norovirus. Sanitizer should contain at least 60% alcohol and be rubbed in until hands are dry.
A CDC says alcohol-based hand sanitizer is preferred in most clinical situations unless hands are visibly soiled.
B Correct: visibly soiled hands call for soap and water.
C Hand hygiene is needed after glove removal, but sanitizer is acceptable then unless hands are soiled.
D Hand hygiene is needed at many points during a shift, and the method depends on whether hands are soiled.
Full lesson
Each part starts with its main idea. Open a part when you want the details.
The short answer: Use alcohol-based hand sanitizer unless hands are visibly soiled or you cared for a patient during a C. difficile or norovirus outbreak; then use soap and water. Clean hands after removing gloves. Put PPE on gown first and gloves last. Keep counting trays clean, and count hazardous drugs only on their own labeled tray.
1 When do you use sanitizer and when do you wash?Alcohol-based hand sanitizer is CDC's default for health care workers, and soap and water is the exception. 1 min
Alcohol-based hand sanitizer is CDC's default for health care workers, and soap and water is the exception. The 2026 PTCE outline lists hand hygiene, PPE and cleaning counting trays, counters and equipment under infection prevention.
| Situation | Method |
|---|---|
| Most routine hand hygiene | Sanitizer with at least 60% alcohol, rubbed until dry (about 20 seconds) |
| Hands visibly soiled | Soap and water, rubbing for at least 15 seconds |
| Caring for a patient during a C. difficile or norovirus outbreak | Soap and water |
When washing, skip hot water, which dries the skin. Rinse, dry with a disposable towel, and use the towel to turn off the faucet. Thumbs, fingertips and the spaces between fingers are the spots most often missed.
2 When must you clean your hands?You clean your hands at set moments, and gloves never replace any of them. 1 min
You clean your hands at set moments, and gloves never replace any of them. CDC's list includes:
- immediately before touching a patient;
- after touching a patient or the patient's surroundings;
- after contact with blood, body fluids or contaminated surfaces;
- immediately after removing gloves.
Hands can pick up contamination as gloves come off, so glove removal always ends with hand hygiene.
3 In what order do you put on and take off PPE?PPE goes on gown first and gloves last, and it comes off starting with the most contaminated items. 1 min
PPE goes on gown first and gloves last, and it comes off starting with the most contaminated items. When engineering and work-practice controls are not enough, OSHA requires employers to provide PPE and train workers to use it.
| Putting on | Taking off (one CDC example) |
|---|---|
| 1. Gown | 1. Gloves |
| 2. Mask or respirator | 2. Goggles or face shield |
| 3. Goggles or face shield | 3. Gown |
| 4. Gloves, pulled over the gown's wrists | 4. Mask or respirator, then hand hygiene |
CDC also shows removing the gown and gloves together. In both versions the mask comes off last, and hand hygiene follows right away.
4 How are counting trays, counters and equipment kept clean?Counting trays, spatulas and countertops are cleaned on a regular schedule and also whenever they are visibly dirty. 1 min
Counting trays, spatulas and countertops are cleaned on a regular schedule and also whenever they are visibly dirty. CDC's disinfection guidance sets that rule for surfaces and equipment, so visible residue means cleaning now, not at the next scheduled time.
- Count with a clean tray and spatula instead of your hands. Open RN's skills checklist says to wear gloves if tablets must be touched.
- Clean trays and counters on the schedule and right away after a spill or visible residue.
- Follow the disinfectant's label directions, which CDC says users of EPA-registered products must do.
EPA's disinfectant steps add two rules. Pre-clean a visibly dirty surface first. Then keep the surface wet for the full contact time on the label.
5 How are hazardous drugs counted?Hazardous drugs are counted on their own labeled tray, which is never used for other drugs. 1 min
Hazardous drugs are counted on their own labeled tray, which is never used for other drugs. NIOSH says to count hazardous drugs carefully with dedicated equipment. U.S. Army Public Health Center guidance, which builds on USP <800>, adds that the hazardous-drug tray is labeled and stored apart from the general trays.
NIOSH also advises against putting hazardous tablets or capsules in an automated counting machine unless that machine is shown not to release powder.
6 What the technician doesThe technician follows these routines every shift and reports any gaps. 1 min
The technician follows these routines every shift and reports any gaps. Clean your hands at each required moment, wear PPE in the right order, and wipe trays and counters on schedule. Keep the hazardous-drug tray separate, and tell the pharmacist about spills or contamination.
Common mistakes
The traps students fall into most. Read these before you practice.
Watch out: Visibly soiled hands need soap and water, not sanitizer.
Watch out: Gloves go on last and come off first, not the other way around.
Watch out: A disinfectant works only if the surface stays wet for the full contact time, not just a quick spray and wipe.
Watch out: Wiping the hazardous-drug tray does not make it a general tray; count other drugs on a general tray.
How to remember it
Two short phrases cover the hand hygiene choice and the PPE order.
Memory hook: "Gloves on last, gloves off first; mask off last." For hand hygiene: "Dirty hands, use the sink."
Self-check:
- Your hands have visible residue after a spill. Sanitizer or soap and water?
- Which PPE item goes on last?
- You just counted a hazardous drug. Which tray do you use for the next, non-hazardous prescription?