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IPC Patient/Visitor use: Hand Hygiene Audits of Staff
Medway Community Healthcare
Start
1. Date
2. Service Name
Medway Community Healthcare
Notes
3. Indication Moment
Before patient contact
Before aseptic task
After patient contact
After body fluid exposure risk
After contact with the patients environment
After Doffing or Before Donning PPE
Notes
4. Hand hygiene action
Wash with soap and water
Alcohol rub
Missed
Notes
5. Duration of Hand Hygiene Action
15-30 seconds
1-15 seconds
30-60 seconds
60 seconds plus
Notes
6. Did they adhere to the Ayliffe technique?
Yes
Partially/Some missed steps
No
Notes
7. Which steps were missed? Please select all applicable answers
Wet Hands (If applicable)
Apply Soap or Gel
Palm to Palm
Palm over back of hand
Palm to palm with fingers interlaced
Backs of fingers to opposing palm
Rotational rubbing of thumbs
Rinse hands (If applicable)
Dry hands (if applicable)
Notes
8. Any barriers? If so, please comment what the barrier is.
No barriers identified
Not bare below the elbow- Watches or Bracelets outside of MCH Policy
Not bare below the elbow- Rings outside of MCH Policy
Not bare below the elbow- Nails outside of MCH Policy
Not bare below the elbow- Incorrect uniform worn for clinical activity
Resources- Lack of or Inadequate Supply of hand hygiene resources
Resources- Poor access to or inconvenient location of hand hygiene facilities
Environmental factors- Water temperature is too cold
Environmental factors- Water temperature is too warm
Environmental factors- Unpleasant experience with hand hygiene products available (please state why in comments)
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