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Hand hygiene audit checklist template

Hand hygiene audit checklist template

Ensure compliance with hygiene standards using this audit checklist. Regular audits help maintain cleanliness and prevent the spread of infections.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
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or Download template as PDF
Hand hygiene audit checklist template

Ensure compliance with hygiene standards using this audit checklist. Regular audits help maintain cleanliness and prevent the spread of infections.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Our hand hygiene audit checklist monitors healthcare workers’ compliance with the WHO’s 5 Moments for Hand Hygiene. It specifically tracks each critical moment—before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, and after touching surroundings. You can easily identify compliance patterns by healthcare worker categories, helping you target training where it’s most needed.

The US Centers for Disease Control and Prevention (CDC) highlights that around one in 31 hospital patients gets at least one healthcare-associated infection on any given day. This checklist provides the structured framework needed to reduce these statistics through systematic observation and documentation of hand hygiene practices across your facility.

Related categories

Preview of the template
Inspection
Hand Hygiene Audit
List the healthcare workers to be observed here:
Healthcare Worker
Name of Healthcare Worker/ ID Number (optional)
Select category:
Unit/ Department:
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:
This template was downloaded 55 times

Frequently asked questions

What’s the best way to observe staff without making them uncomfortable?

Be transparent about the audit process and its purpose—improving patient safety, not punishing individuals. Position yourself naturally in the clinical area without hovering. Consider training peer observers from different departments to normalize the process and reduce the “Hawthorne effect” of changed behavior during observation.

How many observations do I need for meaningful hand hygiene compliance data?

Aim for at least 30 observations per unit or department monthly for statistical significance. This typically requires multiple short observation sessions (15-20 minutes) across different days and shifts. Quality matters more than quantity—ensure your observations capture all five moments across various healthcare worker categories.

How can I use this checklist to improve compliance rather than just measure it

Share the results regularly with staff, highlighting both successes and opportunities. Use specific observations as teaching moments in team huddles. You can also create friendly competition between units by posting compliance rates. Most importantly, address systemic barriers identified during audits, such as inconvenient sanitizer placement or workflow obstacles.

Should I identify individual healthcare workers by name when using this checklist?

Focus on patterns rather than individuals unless your facility’s policy requires identification. Many successful programs use anonymous observation with only role categories noted. This approach reduces defensive reactions and emphasizes system improvement rather than blame. If you track individuals, make sure they understand the constructive purpose.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.