1. Are you washing your hands? Are you observing precautions?
Excellent %
Needs improvement %
Unsatisfactory: Needs major improvement <90%

2. November 2015 Hand hygiene before patient contact/wearing gloves
Percent compliant

3. November 2015 Hand hygiene after patient contact/wearing gloves
Discipline/ Number of observations

4. November 2015 Hand hygiene before touching an invasive device

5. November 2015 Face protection
Percent compliant
Discipline/ Number of observations

6. November 2015 Compliance with precautions
Percent compliant
Discipline/ Number of observations

7. When do you need to wear face protection?
Mask and goggles are necessary for your protection during any procedure that may expose you to splashed or aerosolized body fluids Open suctioning Removal of chest tubes and peritoneal drains Intubation Bronchoscopy Surgical procedures