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Beyond the WHO Five Moments: The Organization’s Role in Hand Hygiene Compliance

Patrick Boshell
October 23, 2013

Healthcare Hand HygieneDebMed supports implementation of the World Health Organization’s (WHO) Five Moments for Hand Hygiene.  Healthcare workers must clean their hands:


  1. Before touching a patient
  2. Before a  procedure
  3. After a procedure or body fluid exposure risk
  4. After touching a patient
  5. After touching a patient’s surroundings  

But simply instructing healthcare workers on how and why to follow the Five Moments will never generate adequate hand hygiene compliance. Healthcare organizations must develop, maintain and support a comprehensive hand hygiene program, making sure that hand hygiene and patient safety are long-term organizational priorities.

Following a risk assessment that identifies barriers to hand hygiene compliance, hospitals should craft a multifaceted strategy to enhance compliance, including securing management support, role model development, education and training, monitoring and reporting, and patient and family involvement.  

Ideally, healthcare organizations should develop-a hand hygiene education and training program that addresses the needs of physicians, nurses, allied health professionals, volunteers, patients and family members. Among the education requirements:


• Indications for hand cleaning, including the WHO Five Moments for Hand Hygiene
• Effective techniques for hand cleaning
• Appropriate use of gloves
• Responses to common hand hygiene barriers including time, skin sensitivities and dermatitis


Equally important is the hospitals role in hand hygiene compliance monitoring and reporting.  This typically involves selection of the best technologies and methods for audit, surveillance, and monitoring and dissemination of compliance feedback to individuals, units and groups with aggregated results provided to management.  Most importantly, it means promoting discussion and dialogue on the implications of hand hygiene compliance findings and recommendations and action steps for improved compliance.


Healthcare organizations must also deliver the tools, including products, dispensers and monitoring devices that make hand hygiene compliance with the Five Moments possible. These resources belong within the workflow and at the point of care, ideally at entrances, exits, triage areas, reception desks, waiting rooms, hallways between patient rooms and nursing stations. Healthcare workers can offer invaluable feedback on issues like the effectiveness of hand hygiene products, risks of contamination, patient and family needs, and the patient care environment.


Hand hygiene is a journey, not a destination.  Achieving the kind of long-term compliance that will safeguard patient safety and minimize the transmission of HAIs requires serious commitment.  Organizations must invest time, resources and people in hand hygiene education, training, monitoring and promotion.     


International Infection Prevention Week 2013 & DebMed


International Infection Prevention WeekIn recognition of, and to shed much needed light on International Infection Prevention Week (Oct 20-26), this is one in a series of blog articles from DebMed dedicated to the World Health Organization’s (WHO) Five Moments for Hand Hygiene.  To view all articles in this series as they become available, please click here.


DebMed is the creator of the world’s first electronic hand hygiene compliance monitoring system based on the World Health Organization’s (WHO’s) Five Moments for Hand Hygiene, and these moments dictate our standards for hand hygiene compliance in a tireless effort to decrease the spread of preventable and deadly hospital-acquired infections.


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