01 Hand Hygiene V2 Online Forms Current User: Not Logged In
Completion Errors
HAND HYGIENE OBSERVATION TOOL
General
Date of Audit
//
Ward / Department
Auditor
Select who is carrying
out this audit
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
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