Who Hand Hygiene Checklist Details

Hand hygiene is critical to protecting both patients and healthcare workers. A hand hygiene observation form can help ensure that all staff are following proper hand hygiene procedures. The form can also be used to track compliance rates, which can help identify areas where improvement is needed. Use of a hand hygiene observation form is an important tool for maintaining adherence to hand hygiene guidelines and preventing the spread of infection. __________________________________________________________________ Are you looking for a way to improve your hospital's hand hygiene compliance? Look no further than the Hand Hygiene Observation Form! This form can help you keep track of how well each member of your staff is following proper hand hygiene procedures.

We've gathered some technical information about the hand hygiene observation form. It's advised that you check out this info before you decide to start fiddling with the form.

QuestionAnswer
Form NameHand Hygiene Observation Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other nameswho hand hygiene checklist pdf, hand hygiene observation form, hand hygiene audit checklist, who hand hygiene checklist

Form Preview Example

Observation Form

Facility:

Service:

Ward:

Department:

Country**:

Period Number*:

 

 

 

 

Session

 

 

 

 

 

 

 

 

Number*:

 

 

 

 

 

Date:

 

 

 

 

Observer:

 

 

 

 

 

/

/

 

(dd/mm/yy)

 

 

(initials)

 

 

 

 

Start/End time:

 

 

 

 

Page N°:

 

:

/

:

 

(hh:mm)

 

 

 

 

 

 

Session duration:

 

City**:

 

(mm)

 

 

 

Prof.cat

 

 

 

Prof.cat

 

 

 

Prof.cat

 

 

 

Prof.cat

 

 

 

Code

 

 

 

Code

 

 

 

Code

 

 

 

Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Opp.

Indication

HH Action

Opp.

Indication

HH Action

Opp.

Indication

HH Action

Opp.

Indication

HH Action

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

1

 

bef-asept.

1

 

bef-asept.

1

 

bef-asept.

1

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

2

 

bef-asept.

2

 

bef-asept.

2

 

bef-asept.

2

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

3

 

bef-asept.

3

 

bef-asept.

3

 

bef-asept.

3

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

4

 

bef-asept.

4

 

bef-asept.

4

 

bef-asept.

4

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

5

 

bef-asept.

5

 

bef-asept.

5

 

bef-asept.

5

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

6

 

bef-asept.

6

 

bef-asept.

6

 

bef-asept.

6

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

7

 

bef-asept.

7

 

bef-asept.

7

 

bef-asept.

7

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

 

bef-pat.

HR

 

8

 

bef-asept.

8

 

bef-asept.

8

 

bef-asept.

8

 

bef-asept.

 

 

HW

 

HW

 

HW

 

HW

 

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

aft-b.f.

 

 

 

missed

 

 

missed

 

 

missed

 

 

missed

 

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

aft-pat.

gloves

 

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

 

 

aft.p.surr.

* To be completed by the data manager.

** Optional, to be used if appropriate, according to the local needs and regulations.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.

Revised August 2009

General Recommendations

(refer to the Hand Hygiene Technical Reference Manual)

1.In the context of open and direct observations, the observer introduces him/herself to the health-care worker and to the patient when appropriate, explains his/her task and proposes immediate informal feed back.

2.The health-care worker, belonging to one of the main four following professional categories (see below), is observed during the delivery of health-care activities to patients.

3.Detected and observed data should be recorded with a pencil in order to be immediately corrected if needed.

4.The top of the form (header) is completed before starting data collection (excepted end time and session duration).

5.The session should last no more than 20 minutes (± 10 minutes according to the observed activity); the end time and the session duration are to be completed at the end of the observation session.

6.The observer may observe up to three health-care workers simultaneously, if the density of hand hygiene opportunities permits.

7.Each column of the grid to record hand hygiene practices is intended to be dedicated to a specific professional category. Therefore numerous health-care workers may be sequentially included during one session in the column dedicated to their category. Alternatively each column may be dedicated to a single health-care worker only of whom the professional category should be indicated.

8.As soon as you detect an indication for hand hygiene, count an opportunity in the appropriate column and cross the square corresponding to the indication(s) you detected. Then complete all the indications that apply and the related hand hygiene actions observed or missed.

9.Each opportunity refers to one line in each column; each line is independent from one column to another.

10.Cross items in squares (several may apply for one opportunity) or circles (only a single item may apply at one moment).

11.When several indications fall in one opportunity, each one must be recorded by crossing the squares.

12.Performed or missed actions must always be registered within the context of an opportunity.

13.Glove use may be recorded only when the hand hygiene action is missed while the health-care worker is wearing gloves.

Short description of items

Facility:

to complete according to the local nomenclature

 

 

Service:

to complete according to the local nomenclature

 

 

Ward:

to complete according to the local nomenclature

 

 

Department:

to complete according to the following standardized nomenclature:

 

medical, including dermatology, neurology,

 

surgery, including neurosurgery, urology, EENT,

 

haematology, oncology, etc.

 

ophthalmology, etc.

 

mixed (medical & surgical), including gynaecology

 

obstetrics, including related surgery

 

paediatrics, including related surgery

 

intensive care & resuscitation

 

emergency unit

 

 

 

long term care & rehabilitation

 

ambulatory care, including related surgery

 

other (to specify)

Period N°:

1) pre- / 2) post-intervention; and then according to the institutional counter.

Date:

day (dd) / month (mm) / year (yy)

 

 

Start/end time:

hour (hh) / minute (mm).

 

 

Session duration:

difference between start and end time, resulting in minutes of observation.

Session N°:

attributed at the moment of data entry for analysis.

 

 

Observer:

observer’s initials (the observer is responsible for the data collection and for checking their accuracy

 

before submitting the form for analysis.

 

 

Page N°:

to write only when more than one form is used for one session.

Prof.cat:

according to the following classification:

 

 

 

1. nurse / midwife

 

1.1 nurse, 1.2 midwife, 1.3 student.

 

2. auxiliary

 

 

 

 

 

3. medical doctor

 

3.1 in internal medicine, 3.2 surgeon, 3.3 anaesthetist / resuscitator / emergency

 

 

 

physician, 3.4 paediatrician, 3.5 gynaecologist, 3.6 consultant, 3.7 medical student.

 

4. other health-

 

4.1 therapist (physiotherapist, occupational therapist, audiologist, speech

 

care worker

 

therapist), 4.2 technician (radiologist, cardiology technician, operating room

 

 

 

technician, laboratory technician, etc), 4.3 other (dietician, dentist, social worker

 

 

 

and any other health-related professional involved in patient care), 4.4 student.

Number:

number of observed health-care workers belonging to the same professional category (same code) as

 

they enter the field of observation and you detect opportunities.

Opp(ortunity):

defined by one indication at least

 

 

Indication:

reason(s) that motivate(s) hand hygiene action; all indications that apply at one moment must be recorded

 

bef.pat: before touching a patient

 

aft.b.f: after body fluid exposure risk

 

bef.asept: before clean/aseptic procedure

 

aft.pat: after touching a patient

 

 

 

 

 

aft.p.surr: after touching patient surroundings

HH action:

response to the hand hygiene indication(s); it can be either a positive action by performing handrub or

 

handwash, or a negative action by missing handrub or handwash

 

HR: hand hygiene action by handrubbing with an

 

Missed: no hand hygiene action performed

 

alcohol-based formula

 

 

 

 

 

 

 

 

 

 

HW: hand hygiene action by handwashing with soap and

 

 

 

water

 

 

 

 

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.

Observation Form – Basic Compliance Calculation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility:

 

 

 

 

 

Period:

 

 

Setting:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prof.cat.

 

 

Prof.cat.

 

 

Prof.cat.

 

 

Prof.cat.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total per session

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Session N°

Opp

HW

HR

Opp

HW

HR

Opp

HW

HR

Opp

HW

HR

 

Opp

HW

HR

 

 

(n)

(n)

(n)

(n)

(n)

(n)

(n)

(n)

(n)

(n)

(n)

(n)

 

(n)

(n)

(n)

1

 

 

 

 

 

 

2

 

 

 

 

 

 

3

 

 

 

 

 

 

4

 

 

 

 

 

 

5

 

 

 

 

 

 

6

 

 

 

 

 

 

7

 

 

 

 

 

 

8

 

 

 

 

 

 

9

 

 

 

 

 

 

10

 

 

 

 

 

 

11

 

 

 

 

 

 

12

 

 

 

 

 

 

13

 

 

 

 

 

 

14

 

 

 

 

 

 

15

 

 

 

 

 

 

16

 

 

 

 

 

 

17

 

 

 

 

 

 

18

 

 

 

 

 

 

19

 

 

 

 

 

 

20

 

 

 

 

 

 

Total

 

 

 

 

 

 

Calculation

Act (n) =

Act (n) =

Act (n) =

Act (n) =

 

Act (n) =

 

Opp (n) =

Opp (n) =

Opp (n) =

Opp (n) =

Opp (n) =

Compliance

 

 

 

 

 

 

 

 

 

Compliance (%) =

Actions

x 100

 

 

 

 

Opportunities

Instructions for use

1.Define the setting outlining the scope for analysis and report related data according to the chosen setting.

2.Check data in the observation form. Hand hygiene actions not related to an indication should not be taken into account and vice versa.

3.Report the session number and the related observation data in the same line. This attribution of session number validates the fact that data has been taken into count for compliance calculation.

4.Results per professional category and per session (vertical):

4.1Sum up recorded opportunities (opp) in the case report form per professional category: report the sum in the corresponding cell in the calculation form.

4.2Sum up the positive hand hygiene actions related to the total of opportunities above, making difference between handwash (HW) and handrub (HR): report the sum in the corresponding cell in the calculation form.

4.3Proceed in the same way for each session (data record form).

4.4Add up all sums per each professional category and put the calculation to calculate the compliance rate (given in percent)

5.The addition of results of each line permits to get the global compliance at the end of the last right column.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.

Observation Form – Optional Calculation Form

(Indication-related compliance with hand hygiene)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility:

 

 

 

 

 

 

 

Period:

 

 

 

Setting:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Before touching a

 

Before clean/ aseptic

 

After body fluid

 

 

After touching a

 

 

After touching

 

 

 

 

 

 

 

 

 

 

patient

 

 

 

procedure

 

 

exposure risk

 

 

patient

 

 

 

patient surroundings

 

 

 

 

 

 

 

 

 

 

 

 

Indic

HW

HR

 

Indic

HW

HR

 

Indic

HW

HR

 

Indic

HW

HR

 

Indic

HW

HR

Session N°

 

 

 

 

 

(n)

(n)

(n)

 

(n)

(n)

(n)

 

(n)

(n)

(n)

 

(n)

(n)

(n)

 

(n)

(n)

(n)

 

 

 

 

 

1

 

 

 

 

 

2

 

 

 

 

 

3

 

 

 

 

 

4

 

 

 

 

 

5

 

 

 

 

 

6

 

 

 

 

 

7

 

 

 

 

 

8

 

 

 

 

 

9

 

 

 

 

 

10

 

 

 

 

 

11

 

 

 

 

 

12

 

 

 

 

 

13

 

 

 

 

 

14

 

 

 

 

 

15

 

 

 

 

 

16

 

 

 

 

 

17

 

 

 

 

 

18

 

 

 

 

 

19

 

 

 

 

 

20

 

 

 

 

 

Total

 

 

 

 

 

Calculation

Act (n) =

Act (n) =

Act (n) =

Act (n) =

Act (n) =

 

Indic1 (n) =

Indic2 (n) =

Indic3 (n) =

Indic4 (n) =

Indic5 (n) =

Ratio

 

 

 

 

 

act / indic

 

 

 

 

 

Instructions for use

1.Define the setting outlining the scope for analysis and report related data according to the chosen setting.

2.Check data in the observation form. Hand hygiene actions not related to an indication should not be taken into account and vice versa.

3.If several indications occur within the same opportunity, each one should be considered separately as well as the related action.

4.Report the session number and the related observation data in the same line. This attribution of session number validates the fact that data has been taken into count for compliance calculation.

5.Results per indication (indic) and per session (vertical):

4.1Sum up indications per indication in the observation form: report the sum in the corresponding cell in the calculation form.

4.2Sum up positive hand hygiene actions related to the total of indications above, making the difference between handwash (HW) and handrub (HR): report the sum in the corresponding cell in the calculation form.

4.3Proceed in the same way for each session (observation form).

4.4Add up all sums per each indication and put the calculation to calculate the ratio (given in percent)

Note: This calculation is not exactly a compliance result, as the denominator of the calculation is an indication instead of an opportunity. Action is artificially overestimated according to each indication. However, the result gives an overall idea of health-care worker’s behaviour towards each type

of indication.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .