SafetyCulture Summit 2020

Hand Hygiene Audit

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

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Published October 21st, 2020

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.

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. This article covers:

  1. How to effectively perform a hand hygiene audit;
  2. Hand hygiene audit tools you can use to streamline reporting; and
  3. Downloadable hand hygiene audit templates.

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 – Washing Technique

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.

Easy-to-use Software for Hand Hygiene Audits and 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


Shine Colcol

SafetyCulture Staff Writer

Shine has been professionally writing about virtually anything since her internship for a digital publisher of niche blogazines. She is passionate about building a culture of continuous improvement in the environmental, health, safety, and quality space through well-researched, engaging, and impactful content.