Hand hygiene

Effective hand hygiene is an evidence-based infection prevention strategy. The National Hand Hygiene Initiative uses a multimodal approach to improving hand hygiene and involves strategies such as:

• Promoting the use of alcohol-based hand rub
• Making handwashing facilities available
• Education
• Monitoring and review of hand hygiene compliance and addressing non-compliance.

Note: The National Hand Hygiene Initiative does not recommend direct observational auditing of hand hygiene compliance in the non-acute and primary care settings. 

• What is your healthcare service’s process for hand hygiene? Is it consistent with the current National Hand Hygiene Initiative and with state or territory requirements?
• How does your healthcare service support the workforce and people who use the service to practise hand hygiene? 
• How does your healthcare service promote hand hygiene to the workforce, patients and consumers?

• Define and implement a process for hand hygiene that is consistent with appropriate elements of the National Hand Hygiene Initiative and relevant state or territory requirements.
• Support the workforce to practise hand hygiene by:
  • providing access to training on hand hygiene 
  • ensuring the workforce has the necessary consumables and facilities, such as alcohol-based hand rubs, soap products and handwashing basins to comply with hand hygiene processes
  • promoting hand hygiene. 
• Display promotional material in the healthcare service to support the workforce and consumers to practise hand hygiene. 
• Encourage the workforce to promote hand hygiene to consumers.
• Ensure compliance with the Australasian Health Facility Guidelines specifications for hand washing facility design and other relevant Australian Standards.
• Ensure monitoring and reporting of workforce hand hygiene compliance.

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

• A demonstrated hand hygiene process that is consistent with the current National Hand Hygiene Initiative and state or territory requirements 
• Training documents (for example, syllabus, attendance records or competency assessments) relating to the hand hygiene program 
• Observation of hand hygiene promotion within the healthcare service.

Commission resources

• What is hand hygiene? – when performed correctly, hand hygiene results in a reduction of microorganisms on hands and contributes to prevention of healthcare-associated infection and improved patient safety. 
• National Hand Hygiene Initiative – part of a suite of initiatives to prevent and reduce healthcare-associated infections in Australian healthcare settings.
• Addendum NSQHS Standards Accreditation Workbook 2021 Infection Prevention and Control Standard – provides users with updated information on reflective questions and examples of evidence for the 2021 Preventing and Controlling Infections Standard within the NSQHS Standards. Principles and strategies are broadly applicable.
• Infection Prevention and Control eLearning Modules – for hand hygiene (separate modules for the clinical and non-clinical workforces).
• Infection prevention and control resources for consumers – a series of fact sheets for consumers and carers about infection prevention and control, and common and emerging healthcare-associated infections.
• Audit tools for non-acute settings, including primary care and mental health – tools to support hand hygiene auditing in acute and non-acute healthcare settings.