Educational exam prep, not medical advice. This page teaches what certification exams test. Follow your facility’s policies, your supervising clinician and the manufacturer’s instructions in practice. If you are a patient with a health question, talk to your clinician or see MedlinePlus.
Step by step
- Greet and explain
Address the resident by name and introduce yourself (NNAAP scores this as part of the skill).
- Turn on the water
Stand back so your uniform does not touch the sink.
- Wet hands and wrists
Keep hands lower than elbows so water runs toward the fingertips.
- Apply soap and lather
Cover palms, backs of hands, between fingers, thumbs, under nails and wrists.
- Scrub with friction for at least 20 seconds
CDC guidance for soap and water is at least 20 seconds of rubbing.
- Rinse fingertips down
Rinse wrists to fingertips without touching the sink.
- Dry with a clean paper towel
Dry from fingertips to wrists and discard the towel.
- Turn off the faucet with a clean, dry paper towel
Then discard it. Touching the faucet with a bare clean hand recontaminates you.
Critical points that fail candidates
- Touching the inside of the sink or the faucet with clean hands.
- Scrubbing for less than 20 seconds.
- Pointing fingertips up while rinsing.
- Forgetting to wash at all. In Prometric states (Florida, Texas, Louisiana, New York) handwashing is scored on every skills test and you are not prompted.
Who tests it
| Vendor | How hand hygiene is tested |
|---|---|
| Prometric | Scored on every skills test, unprompted, at the beginning |
| Credentia (NNAAP) | A stand-alone skill that can be drawn; also expected throughout other skills |
| Headmaster (D&SDT) | Built into task steps; handbooks show hand sanitizer steps (cover all surfaces, rub until dry) |
Soap and water vs. hand sanitizer
CDC recommends alcohol-based hand rub for most clinical situations and soap and water when hands are visibly soiled. On the exam, follow the method your state skill requires. For sanitizer steps, cover all surfaces of the hands and rub until completely dry.
Printable self-check
- [ ] Introduced myself and addressed the resident by name
- [ ] Did not lean on the sink
- [ ] Hands below elbows while wetting and rinsing
- [ ] Lathered all surfaces including between fingers and under nails
- [ ] Counted at least 20 seconds of friction
- [ ] Rinsed fingertips down
- [ ] Dried with a clean towel and discarded it
- [ ] Turned off faucet with a clean, dry towel
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Frequently asked questions
How long should a CNA wash their hands?
Rub with soap for at least 20 seconds (CDC). Many candidates count slowly to 30 to be safe.
Is handwashing always on the CNA skills test?
In Prometric states, yes - it is scored on every skills test without prompting. With Credentia and Headmaster, hand hygiene is expected within skills even when it is not a separate task.
Can I use hand sanitizer on the CNA skills test?
Only if your state’s skill checklist uses sanitizer (some Headmaster task steps do). Use soap and water when hands are visibly soiled.
What is the most common handwashing mistake?
Turning off the faucet with a bare clean hand or touching the sink basin.
Sources
- CDC - Clinical Safety: Hand Hygiene for Healthcare Workers (accessed 2026-09-23)
- North Carolina Nurse Aide I Candidate Handbook (Credentia) (accessed 2026-09-23)
- Prometric - Florida CNA Candidate Information Bulletin (Rev. 11/01/2025) (accessed 2026-09-23)
- D&SDT-Headmaster - Minnesota Nurse Aide Candidate Handbook (June 2026) (accessed 2026-09-23)