01 Hand Hygiene V2
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HAND HYGIENE OBSERVATION TOOL
General
Date of Audit
/
/
Ward / Department
Brixham
Dawlish
Teign
Templar
Totnes
John MacPherson
Louisa Cary
Special Care Baby Unit
EAU4
ED
AMU
CCU
Cheetham Hill
Dunlop
George Earle
Midgley
McCallum
New Forrest
Simpson
Turner
Ainslie
Allerton
Cromie
Ella Rowcroft
SRU
Warrington
Discharge Lounge
RGDU (Ricky Grant Day Unit
Cardiac Catheter Suite
SSPAU
ED PAEDS
Auditor
Select who is carrying
out this audit
Infection Control team
Link Practitioner
Matron
Ward Manager
Senior Nurse
Other
Is this Audit by:
IP&C Teams
Cross Audit
Your Own Audit
Peer Review
Is this Audit the:
Additional
Regular Monthly
OBSERVATIONS
Staff Category
Please chose from one of the categories in the picklist to describe the person being observed
Other (please specify below)
Picklist
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Registered Nurse
HCSWs
Doctor
Facilities
Therapy staff (physio,OT salt)
Porters
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Hand Hygiene Observations
Before patient contact?
Moment 1
Before an aseptic technique?
Moment 2
After contact with bodily fluids?
Moment 3
After patient contact?
Moment 4
After contact with patient surroundings?
Moment 5
Yes
No
Not applicable
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