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Hand Hygiene Audit Form

You can use this hand hygiene audit checklist to evaluate hand hygiene practices based on WHO's five moments for hand hygiene and automatically scale the overall compliance score of unlimited hand hygiene inspections.
Rated 5/5 stars on Capterra

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  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 5/5 stars on Capterra
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Hand Hygiene Audit Form

Inspection

Hand Hygiene Audit

List the healthcare workers to be observed here:

The Five Moments of Hand Hygiene

Before contact to the patient?

After contact to the patient?

After contact with surroundings of the patient?

After exposure to body fluid?

Before an aseptic procedure?

Completion

Recommendations:

Auditor's full name and signature:

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