close
lumiform
LumiformMobile audits & inspections
Get AppGet App

Hand Hygiene Compliance Checklist Template

Use this hand hygiene compliance checklist to internally evaluate the hand hygiene techniques of healthcare workers. This checklist can be used to easily monitor performance quality and provide feedback with photo evidence.
Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • 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
App StorePlay Store

Hand Hygiene Compliance Checklist Template

Inspection

Hand Hygiene Compliance

The World Health Organization guidelines for Hand Hygiene Technique

Name of Healthcare Worker

Select healthcare worker category.

Please specify.

Hand Hygiene Technique

Identify the moment.

Which hand hygiene technique did the healthcare worker perform?

Hand Hygiene Technique with Alcohol-Based Formulation (20-30 seconds)

Is the healthcare worker not wearing a stoned ring?

Are the nails of the healthcare worker short and clean?

Did the healthcare worker perform correct hand hygiene technique?

Hand Hygiene Technique with Soap and Water (40-60 seconds)

Is the healthcare worker not wearing a stoned ring?

Are the nails of the healthcare worker short and clean?

Is the healthcare worker not wearing a wristwatch?

Is the clothing of the healthcare worker 'bare below the elbows'?

Did the healthcare worker perform correct hand hygiene technique?

Completion

Overall Recommendations

Full Name and Signature of Auditor

Share this template:

Similiar templates