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Hand Hygiene Audit

Prevent the spread of infection in patient care by reinforcing proper handwashing techniques

Published 15 Sep 2021

What is Hand Hygiene Audit?

Hand hygiene audit is the process of making sure that hand hygiene techniques being practiced in healthcare follow recommended guidelines. Hand hygiene audit aims to prevent the spread of infection between healthcare workers and patients through observational inspections of handwashing techniques.

This article covers:

What is Hand Hygiene Compliance?

Hand hygiene compliance is a health and safety policy that is required of health care providers. This policy helps in reducing incidences of health-related infections, therefore protecting both patient and healthcare workers. It may seem like a simple policy, however, negligence to it will negatively impact a healthcare institution’s morbidity rate, duration of hospital stays, and treatment prices.

In a study about Antimicrobial Resistance & Infection Control, it was concluded that a good hand hygiene compliance is achieved when health care providers are well trained and have better knowledge and understanding of the hand hygiene guidelines and techniques. Other factors that affect compliance are the attitude of healthcare providers towards hand hygiene, and the presence of soap and water, and alcohol or sanitizers in the working area.

Why Perform Hand Hygiene Audits?

While easily avoidable, acquiring infection during the ordinary course of patient care remains a leading cause of death and disability worldwide – with over 1.4 million cases occurring at any given time. The simplest and most effective solution to prevent the spread of infection in healthcare is for healthcare workers to practice proper hand hygiene techniques during the five moments of patient care.

Healthcare facilities should perform regular hand hygiene audits to identify training gaps and remind staff of the importance of basic infection control.

How to Perform a Hand Hygiene Audit

Based on the World Health Organization (WHO) hand hygiene guidelines for 2019, the WHO recommends these key steps to follow when performing a hand hygiene audit of healthcare workers:

  1. Communicate with the facility

    Contact the hospital administration before commencing the audit. Announce the period of observation and the purpose of performing the hand hygiene audit. Inform healthcare workers about the data documentation method (e.g. photo evidence).

  2. Identify specific areas to audit

    Audit all areas where patient care is regularly undertaken. Introduce yourself to the head nurse, the chief doctor of the unit or the department manager and provide a general explanation of the role of the observer. Aim to perform a sufficient number of observations across various wards and departments.

  3. Maintain patient privacy

    Patient privacy must not be compromised during auditing. Written permission from patients may be required. Do not audit during extreme situations (e.g. emergency medical treatment, signs of uncontrolled stress in a healthcare worker).

  4. Observe an individual healthcare worker

    Conduct the audit according to the WHO’s Five Moments of Hand Hygiene:

    • Before touching a patient
    • Before clean/aseptic procedures
    • After body fluid exposure/risk
    • After touching a patient
    • After touching patient surroundings

    Indicate whether or not the healthcare worker used the following techniques:

    Hand Hygiene Audit - Washing Technique

    Hand Hygiene Technique | WHO

  5. Document and share key findings

    Provide feedback to the healthcare worker if hand hygiene was not performed. Compliance scores can be determined by the ratio of the number of performed actions (hand hygiene) to the number of opportunities (moments). Results should be shared with management, department heads, boards as well as front-line healthcare workers.

Example of a Hand Hygiene Audit Checklist

Easy-to-use Hand Hygiene Audit Tool for Real-time Reporting

Healthcare auditors can use digital hand hygiene audit tools such as iAuditor by SafetyCulture to streamline data gathering and reporting. iAuditor is an inspection and corrective action tool you can learn in minutes and be used by auditors to:

  • Perform easy hand hygiene audits on a mobile device
  • Capture and store unlimited photos of hand hygiene observations
  • Automatically track compliance scores across 5 moments
  • Generate and share key findings before leaving the facility

SafetyCulture Content Specialist

Shine Colcol

Shine Colcol is a content writer and researcher for SafetyCulture since 2019, mostly covering topics about health and safety, environmental, and operations management. She is passionate in empowering teams to build a culture of continuous improvement through well-researched and engaging content. Her experience in cross-industry digital publishing help enrich the quality of information in her articles.

Shine Colcol is a content writer and researcher for SafetyCulture since 2019, mostly covering topics about health and safety, environmental, and operations management. She is passionate in empowering teams to build a culture of continuous improvement through well-researched and engaging content. Her experience in cross-industry digital publishing help enrich the quality of information in her articles.