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Hand Hygiene Observation
Designation of person completing hand hygiene
MCP
RCP
LPN
Housekeeper
Culinary Team
Resident
Admin
Screener
Life Enrichment
Name of person being audited
Did they perform hand hygiene? (If no, please provide the reason: hands full, frequent entry/exit, dispenser empty, improper glove use, or other
What method?
Did they spend 15-20 seconds washing their hands? For alcohol based hand rub (ABHR) did they rub their hands together vigorously ensuring contact with all surfaces of hands and let dry?
Hand Hygiene Moment
Entry of suite
Exit of suite
Before donning gloves
After removing gloves
After contact with blood or bodily fluids
Before dining
After using washroom
After resident contact
Before putting on mask
Screening
Other:(Please specify in notes)
Do fingernails meet Hand Hygiene Policy? ( No artificial nails, no overlays, no chipped fingernail polish, nails 1/4 inch or less in length?)
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