Hand Hygiene Observation Form
Direct observation of the Five Moments — the WHO gold-standard method, one 20-minute session per sheet
What it is
The WHO observation form: an observer records, for each opportunity, which Moment applied and whether a hand rub, a hand wash, or nothing was done. Produces a compliance rate per ward per profession.
Where to use it
Infection-control nurse or trained observer; one sheet per 20-minute session; at least 200 opportunities per ward per quarter. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention. Evidence for: Universal Floor — hand hygiene; Hospital Standard 3 — environment and infection prevention.
Translate and adapt
English master edition. Georgian and other translations are added as they are clinically reviewed. Any facility may translate, add its logo and adapt wording to local practice — keeping the ASF block, the source attribution and the licence line on the sheet. Clinical thresholds and drug doses must be confirmed against national protocols before use.
The same code is printed on the tool itself. Scan it in any facility to reach this page.
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