Hand Hygiene Observations

Hand Hygiene Observation #1
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #2
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #3
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #4
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #5
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #6
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #7
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #8
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #9
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #10
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #11
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #12
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #13
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #14
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #15
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #16
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #17
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #18
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #19
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #20
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #21
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #22
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #23
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #24
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Hand Hygiene Observation #25
Date & time
Professional category:
Specialty / Function:
Specialty/Function
Specialty / Function:
Compliant hand hygiene opportunity(ies):
Non-compliant hand hygiene opportunity(ies)
Observable non-compliance factors:

Comment:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.