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Hand Hygiene Audit Form

A Hand Hygiene Audit Form is a tool used to measure and evaluate the effectiveness of hand hygiene practices among healthcare workers. It collects data on the frequency of use of hand hygiene products, compliance with hand hygiene policies, and other indicators of good hand hygiene. The form is used to help healthcare professionals improve their hand hygiene practices and reduce the spread of infection. You can use this hand hygiene audit form 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.

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Hand Hygiene Audit Form


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?


Auditor's full name and signature:
Share this template:
A Hand Hygiene Audit Form is an important tool for monitoring and assessing hand hygiene practices in healthcare facilities. It is used to track the frequency and quality of hand hygiene among healthcare workers. The form is designed to ensure that healthcare staff are following the correct hand hygiene practices and to identify areas where improvements can be made. Hand hygiene audit forms typically include questions related to the frequency of hand washing, the use of soap, the use of alcohol-based hand sanitizers, glove use, and the use of hand sanitizer. The form can be used to assess the knowledge, attitudes, and practices of healthcare workers regarding hand hygiene. The audit form can also be used to evaluate the effectiveness of the hand hygiene program and make necessary changes.