Use this hand hygiene audit checklist to assess hand hygiene practices based on WHO's Five Moments and automatically measure the overall compliance score of unlimited hand hygiene observations.
Scan this QR code to use this paper checklist on your smartphone or tablet or
visit
https://safetyculture.com/
Title Page
Site conducted
Facility
Location
Name of Auditor
Date of Audit
Hand Hygiene Audit
Is the patient on Isolation Precautions?
Is notification visible outside of room?
Healthcare Worker
Select healthcare worker category.
Nurse
Medical Doctor
Lab
Radiology
CNA
Transporter
Other
Ward/ Unit/ Department
The Five Moments of Hand Hygiene
Before patient contact
Before an aseptic prodecure
After body fluid exposure
After patient contact
After contact with patient surroundings
Completion
Overall Recommendations
Full Name and Signature of Auditor
Becky Bannister
Hand Hygiene Audit Checklist
Use this hand hygiene audit checklist to assess hand hygiene practices based on WHO's Five Moments and automatically measure the overall compliance score of unlimited hand hygiene observations.
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions.
The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction.
You should independently determine whether the template is suitable for your circumstances.