Hand hygiene compliance is often at the top of infection control priorities, and with good reason. Hand hygiene remains the simplest and most effective preventative measure in curbing the spread of disease in communities and healthcare facilities.

The Five Moments of Hand Hygiene

The Five Moments of Hand Hygiene were developed in 2009 as an international benchmark in response to hand hygiene compliance rates as low as 25%–30%. The visualisation of a palm and five key moments was conceptualised to cover the geographical touch points within a healthcare environment where pathogens are easily spread.

Chances are that you’ve seen the Five Moments of Hand Hygiene in some form or another around your workplace. The Five Moments for Hand Hygiene are:

  1. Before touching a patient
  2. Before clean/aseptic procedure
  3. After body fluid exposure risk
  4. After touching a patient
  5. After touching patient surroundings
Source: https://www.who.int/campaigns/world-hand-hygiene-day

Divide and conquer

As part of this framework, the healthcare environment was divided into three key areas: the patient zone (immediate surroundings where a patients flora resides), critical sites (natural orifices such as mouth and eyes and any medical devices or wounds) and the ‘healthcare zone’ (anything outside the immediate patient zone). Breaking the workplace into these key areas makes it easier for staff to determine the risk of infection, and therefore the need for hand hygiene.

Hand hygiene compliance

Hand hygiene compliance rates within New Zealand DHBs have improved using the Five Moments of Hand Hygiene resource strategy. Whereas compliance rates were 60% in 2012, in October 2020 the national compliance rate was 86.8%.

In Australia, two years after the implementation of the National Hand Hygiene Initiative (which included the Five Moments), hand hygiene adherence increased nearly 25%, with 73.6% of nursing staff compliant with the new program.

The World Health Organization (WHO) World Hand Hygiene Day theme for 2021 is ‘achieving effective hand hygiene at the point of care’. For those working in health care, this means adhering to the ‘5 moments for hand hygiene’: performing hand hygiene before and after contact with a patient or when performing a procedure and after leaving their surroundings.

Dr Sally Roberts, clinical lead for the Health Quality & Safety Commission’s infection prevention and control programme.

Some handy reminders about hand hygiene

  • Hand sanitisers can be used as often as necessary when hands are not visibly soiled.  
  • Use hand moisturiser between hand washing to decrease the irritation.
  • It can be safer to wash your hands frequently than to wear gloves.
  • Gloves are standard procedure in many clinical situations, however they are not a substitute for hand hygiene.
  • Wash your hands before and after glove use.
  • Forgetting to stop and hand wash can cost lives.

Hand hygiene is crucial, but for it to be effective, staff need to be not only doing it regularly, but also properly. Hand Hygiene Australia and the Health Quality and Safety Commission New Zealand are just two sources of hand hygiene resources that you can print out and display at your facility. There are also products available, like Bug Control’s Hand Hygiene Training Kits, that will show your staff the areas they’re missing when they’re hand washing.

NZ Resources

https://www.hqsc.govt.nz/our-programmes/infection-prevention-and-control/publications-and-resources/publication/4277/%5d

References