Hand hygiene in the healthcare environment

Hands are the main pathways of germ transmission during health care and in the community.

Effective hand hygiene is considered to be one of the most important and simple measures available in preventing the spread of healthcare associated infections. It is also a key behaviour to prevent transmission of COVID-19 and so this year, more than ever, effective hand hygiene is critical, for staff and the community.

The most common complication affecting patients in hospital is healthcare associated infections, with around 165,000 reported cases in Australian acute healthcare facilities each year.

Studies show that effective hand decontamination can significantly reduce the rate of healthcare associated infection.

World Hand Hygiene Day

World Hand Hygiene Day, 5 May, is part of a major global effort led by the World Health Organization (WHO) and supported by SA Health annually. This day aims to support health-care workers to improve hand hygiene in health care and accordingly support the prevention of often life-threatening healthcare associated infection (HAI).

The 2022 World Health Organization's campaign message is "Unite for safety: clean your hands"

National Hand Hygiene Initiative

As part of the World Health Organization's First Global Patient Safety Challenge, the Australian Commission on Safety and Quality in Health Care (ACSQHC) established the National Hand Hygiene Initiative (NHHI). Compliance with hand hygiene according to the WHO '5 moments'  is recorded by specially trained and validated auditors. Hospitals are required to submit data three times per year according to the NHHI schedule. The number of 'moments' required to be audited is proportional to the size of the hospital.

In South Australia, hand hygiene compliance is a key performance indicator of patient safety and quality of health care delivery. SA Health has provided several resources to assist healthcare facilities to implement the NHHI program. Healthcare facilities can contribute hand hygiene data to national and local audits.

For more information refer to the ACSQHC NHHI Website.

Policy directive, guideline and supporting resources

The SA Health Hand Hygiene Policy directive (PDF 299KB) establishes a uniform approach to hand hygiene across the public health sector. The associated SA Health Hand Hygiene Guideline (PDF 223KB) summarises best practice for healthcare workers in the clinical setting.

Facilities not meeting the requirements for national data submission may choose to utilise the SA Health observational audit tool (PDF 366KB), to estimate overall hand hygiene compliance and is in keeping with the 5 Moments for hand hygiene.

Hand Hygiene compliance rates across SA Health

Compliance rates of hand hygiene are checked annually across SA Health. Here is how we all measured up: 

Audit tools

NHHI audit tools are available via the National Hand Hygiene Initiative audit tool page, including:

  • 5 Moments for Hand Hygiene compliance audit tools
  • Audit tools for non-acute settings, including primary care and mental health
  • Audit tools for Dental
  • Practice guideline and audit tool for blood collection
  • Practice guideline and audit tool for dialysis

A SA Health hand hygiene competency tool (PDF 87KB) has been developed to assess staff competency in carrying out an effective hand hygiene rub or wash.

Health-care facilities can track their progress in hand hygiene resources, promotion, activities, plan their actions and aim for improvement and sustainability through the use of the following resources:

Educational resources

NHHI educational resources

Since the 1 November 2019, the ACSQHC has managed the NHHI program, including education packages, resources and the national database of hand hygiene compliance audit results. Included is a suite of eLearning modules to provide information on the principles of infection prevention and control in the Australian healthcare setting. Many of these modules add value to those involved in aged care, the community more generally, or workforce groups, such as beauticians.

If you are having difficulty accessing the online learning modules, for problem-solving the ACSQHC offer a range of frequently asked questions.

The Basics of Infection Prevention and Control is suitable for all health care workers and health care students and may also be suitable for other industries where infection prevention and control are important. This module provides a basic orientation and foundation on which to build your infection prevention and control knowledge.

The general hand hygiene auditor training pathway will assist you to become a Hand Hygiene General Auditor (GA).

SA Health eLearning courses

Infection prevention courses are available to all SA Health employees to support the National Safety and Quality Health Service Standards. There are currently three infection prevention related courses available to staff:

  • Infection Prevention and Control
  • Aseptic Technique
  • Safe Use of Personal Protective Equipment (PPE)

For further information, visit the Infection control education and training page.

Fact sheets, posters and promotional materials

The following fact sheets have general information on the use and selection of alcohol-based hand rub products and the appropriate use of gloves in health care.

Click on the below images to download the relevant poster.

Hand hygiene poster - So You&aposre Worred.Hand hygiene poster - Clean hands save livesHand hygiene poster - Go ahead clean your handsHand hygiene poster - You had me at clean hands Hand hygiene poster - Stop & Clean Before Contact Hand hygiene poster - I feel the need, the need for clean handsHand hygiene poster - Hands clean now you mustHand hygiene poster - I see clean handsHand hygiene poster - I&aposll be back after I clean my hands

Further information

For further information on hand hygiene contact SA Health Infection Control Service on (08) 7425 7161.