Hand Hygiene Competency Assessment Form Frontline Staff v1 Dec 22 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name, designation, service/ward, and the name of the assessor in the designated fields at the top of the form.
  3. Review the assessment criteria for hand preparation. Ensure that hands and wrists are free from jewelry, nails are short, and any cuts are covered. Mark 'Achieved' or 'Not Achieved' accordingly.
  4. Follow the hand washing technique section carefully. As you perform each step, check off each technique as completed to ensure thoroughness.
  5. For drying, confirm that hands are dried thoroughly using paper towels and that taps are turned off appropriately. Again, mark your achievement status.
  6. Answer the assessors' questions regarding hand hygiene knowledge in the provided space. This will help demonstrate understanding of key concepts.
  7. Finally, sign and date the form along with your assessor to complete the assessment process.

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As soon as you detect an indication for hand hygiene, count an opportunity in the appropriate column and cross the square corresponding to the indication(s) you detected. Then complete all the indications that apply and the related hand hygiene actions observed or missed.
Follow these five steps every time. 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. Scrub your hands for at least 20 seconds. Rinse your hands well under clean, running water.
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.
How to fill out WHO Observation Form Obtain the WHO Observation Form from the appropriate source. Review the guidelines for completing the form to ensure accuracy. Fill out the date and your name at the top of the form. Document the observational details such as location, duration, and specific activities observed.
The NHHI learning modules do not have an allocated number of CPD points. Self-directed learning earns 1 CPD point per hour of study, therefore each learner should keep a record of the length of time taken to complete the module for their own records.

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To fill out the form, ensure that the name and level of the program, facilitator, and location are noted in the top row. Also note the observers name, observation date, duration, lesson #, and # of participants. Follow the guidelines for scoring and completion of the observation form. Use your best judgment.
Background: Direct observation of hand hygiene is the standard practice recommended by the World Health Organization to monitor its compliance. Objective: To evaluate the accuracy of hand hygiene observation performed by units observers.

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