1. Hand Hygiene The 5 Moments
CAC

2. Nothing’s Changed: Hand Hygiene is Still Important!
It protects the patient, yourself and the health-care environment from harmful germs carried on your hands
 Hand hygiene is the #1 way to prevent the spread of infections!

3. Overview The Five Moments Patient Zone Observations Accountability
Immediate Feedback

4. The World Health Organization’s 5 Moments of Hand Hygiene

5. Background Why 5 Moments?
Focus on moments when pathogen transmission occurs
Best practice, best for patients
Build awareness
Regulatory citations
Best practice – per WHO and CDC recommendations cite
Regulatory citations: focus on point of care/5 moments.. Cite based on BJH HH policy
MD needs a case study

6. *In accordance with patient zone
Moment 1*:
When: Clean your hands before touching a patient or their immediate surroundings
Immediate surroundings
Bedside table
Chair
Bed rails
Linens & etc
Activities
Physical exam
Device manipulation
Assisting with patient movement
*In accordance with patient zone

7. Moment 2:
When: Clean your hands immediately before performing any clean/aseptic procedures
inserting/removing IV
wound care (ex: dressing change)
drawing labs
inserting/removing foley
before meds
before accessing any line

8. Moment 3:
When: Clean your hands immediately after exposure to blood or bodily fluids
obtaining specimens
manipulating lines in any way [including insertion and removal]
wound care
invasive procedures

9. *In accordance with patient zone
Moment 4*:
When: Clean your hands after touching a patient
physical exam
handshake
moves
blood pressure
ambulation
clinical patient care
*In accordance with patient zone

10. *In accordance with patient zone
Moment 5*:
When: Clean your hands after touching the patient’s immediate surroundings
bed rails
over-bed table
chair
linens
door handles
light switches, chairs, etc.
*In accordance with patient zone

11. Understanding the Patient Zone
Perform hand hygiene prior to touching the patient or their environment (ie: something located within the patient zone)
Move freely between the patient and their environment
i.e. May touch immediate surroundings and then touch patient without performing hand hygiene, or vice versa
Hand hygiene should still be performed:
Before clean/aseptic tasks
After exposure to blood
Perform hand hygiene prior to exiting the space
i.e. After touching the patient or their surroundings

12. Patient Zone
The patient zone includes the patient and their immediate surroundings
Private room/bay = anything with the room/bay
Shared spaces = anything which is currently dedicated to that specific patient
Overbed tables, bed rails, WOWs, PCAs, chair, etc.
What is not in the patient zone?
Items/areas that are likely to be contaminated w/ more than just that patient’s germs
Ex: Computers shared between multiple patients at the same time or located in common areas; door handles; curtains

13. Understanding the Patient Zone

14. A Tricky Component: Gloves
Hand hygiene should be performed before donning gloves to complete “before” moments
Includes prior to entering the room
Glove changes require hand hygiene if one of the 5 moments are encountered
AND
Hand hygiene is still required upon removal of gloves to complete the “after” moment
Hand hygiene is always required prior to donning sterile gloves
Hand hygiene should be donned prior to donning gloves at room entry, always.

15. Observations- what has changed?
Direct observations of hand hygiene practices
Observers will observe in patient rooms, during patient care activities
Immediate feedback provided to HCW
Observers will give feedback on what they observed to the HCW whenever possible.
Feed back will be provided outside of the patient room, not in the presence of patients or visitors
When feed back is delivered from an observer, the appropriate response is “Thank you”
Any questions or concerns should be directed to Infection Prevention
Hand hygiene should be donned prior to donning gloves at room entry, always.

16. The first step is getting everyone to do hand hygiene..
Another day..
..but of course, how we perform hand hygiene is also important..

17. THANK YOU for your commitment to patient safety!
#wuCares #accountability #everyhandeverytime
THANK YOU for your commitment to patient safety!