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The average level of compliance with recommended HH techniques among healthcare workers was 78%, which is below the benchmark of 90% for critical care areas. Direct observation is still superior as it can determine compliance with all 5 moments of HH.
Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds.
The general guidance is that a minimum of 1215 observations should be in the denominator before a percentage is calculated. For example, if you have only 4 observations in the denominator and 2 of the HCWs (the numerator) properly washed their hands this produces a 50% compliance number (2/4 = 50%).
OSHA requires employees to immediately wash hands after removal of gloves and/or following contact with blood or other potentially infectious material (OPIM). Many state dental boards require adherence to CDC recommendations, which call for hand hygiene before and after each patient.
The three major methods used are direct observation, self-report and indirect measurement of hand hygiene product usage.
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How to Perform a Hand Hygiene Audit Communicate with the facility. Contact the hospital administration before commencing the audit. Identify specific areas to audit. Audit all areas where patient care is regularly undertaken. Maintain patient privacy. Observe an individual healthcare worker. Document and share key findings.
Observations are usually performed by trained and validated observers who observe care activity directly and count the occurring hand hygiene opportunities and determine the proportion being met by hand hygiene actions.

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