Hand Hygiene Audit

• Conducted on

  Date

• Prepared by

• Location
  Address

• Hand Hygiene before touching a patient

  Yes

  No

  N/A

• Hand hygiene after body fluid exposure risk

  Yes

  No

  N/A

• Hand hygiene after touching patient

  Yes

  No

  N/A

• Hand hygiene after touching patient surroundings

  Yes

  No

  N/A

• Hand hygiene before patient procedure

  Yes

  No

  N/A

Comments and actions needed

• Comments and actions needed