HAND HYGIENE COMPLIANCE CHECKLIST

Created by ChecklistGuro (https://checklistguro.com)

--- AVAILABILITY OF HAND HYGIENE FACILITIES ---
[ ] Number of Sinks with Soap Available
[ ] Number of ABHR Dispensers Available
[ ] Are sinks easily accessible to staff and patients? (Yes, No, Partially)
[ ] Are ABHR dispensers placed at strategic points (e.g., entrances, exits, patient rooms)? (Yes, No, Partially)
[ ] Location of nearest hand hygiene facility for high-risk areas (e.g., isolation rooms, surgical suites)
[ ] Are hand hygiene facilities adequately lit? (Yes, No, N/A)
[ ] Any observed barriers to access or usability of hand hygiene facilities?

--- SOAP AND WATER AVAILABILITY ---
[ ] Number of Sinks Available
[ ] Soap Type Available (Liquid, Bar, Powder) (Liquid Soap, Bar Soap, Powdered Soap)
[ ] Soap Dispenser Functionality (Fully Functional, Partially Functional (needs repair), Not Functional (needs replacement))
[ ] Number of Functional Soap Dispensers
[ ] Water Temperature - Acceptable? (Yes - Warm Enough, No - Too Cold, No - Too Hot)
[ ] Comments/Observations regarding Soap and Water Availability
[ ] Hot and Cold Water Mixing Valve Functionality (Functional, Needs Maintenance, Not Functional)

--- ALCOHOL-BASED HANDRUB (ABHR) AVAILABILITY ---
[ ] Number of ABHR dispensers present
[ ] Locations of ABHR dispensers (list all)
[ ] ABHR dispenser type (e.g., wall-mounted, freestanding) (Wall-mounted, Freestanding, Automatic, Manual)
[ ] ABHR dispenser functionality (Fully functional, Leaking, Clogged, Empty, Damaged)
[ ] ABHR volume remaining in each dispenser (in liters/oz)
[ ] Date of last ABHR refill
[ ] Notes on dispenser condition or issues (if any)
[ ] Are dispensers accessible to patients/visitors? (Yes, No, Partially)

--- SIGNAGE & EDUCATION ---
[ ] Number of Hand Hygiene Signage Posters Displayed in Patient Care Areas
[ ] Number of Hand Hygiene Signage Posters Displayed in Staff Areas
[ ] Signage Content - Does it include 'When to Clean Hands?' (Yes, No, Not Applicable)
[ ] Signage â€“ Are signs in appropriate languages for the patient population? (Yes, No, Not Applicable)
[ ] Describe any educational materials available to staff regarding hand hygiene (e.g., training modules, quick reference guides)
[ ] Upload a sample copy of the staff hand hygiene training material
[ ] Are patient education brochures or materials on hand hygiene readily available? (Yes, No, Not Applicable)
[ ] Describe how patient/visitor hand hygiene is promoted (e.g., reminders at entrances, posters in waiting areas)

--- OBSERVATION OF STAFF HAND HYGIENE PRACTICES ---
[ ] Number of Staff Observed
[ ] Number of Opportunities for Hand Hygiene Observed
[ ] Number of Times Staff Performed Hand Hygiene with Soap & Water
[ ] Number of Times Staff Used Alcohol-Based Handrub
[ ] Number of Times Hand Hygiene Was Missed (Opportunity Present, Not Performed)
[ ] Was appropriate technique used (Soap & Water)? (Yes, No, Not Observed)
[ ] Was appropriate technique used (ABHR)? (Yes, No, Not Observed)
[ ] Comments/Notes on Staff Hand Hygiene Practices (e.g., specific observations, deviations from protocol)
[ ] Did staff wear appropriate PPE (gloves) when indicated? (Yes, No, Not Applicable)

--- WASTE DISPOSAL ---
[ ] Are designated waste containers for contaminated materials readily available near hand hygiene stations? (Yes, No, N/A)
[ ] Are waste containers properly labeled for infectious waste? (Yes, No, N/A)
[ ] How many waste containers are dedicated for disposal of used gloves and wipes?
[ ] Are waste containers lined with appropriate bags? (Yes, No, N/A)
[ ] Describe any observations related to improper waste disposal practices (e.g., overflowing bins, mixed waste streams).
[ ] Date of last waste container liner replacement
[ ] Are staff trained on proper waste segregation procedures? (Yes, No, N/A)

--- MAINTENANCE AND REPLENISHMENT ---
[ ] Frequency of Soap Replenishment (days)
[ ] Frequency of ABHR Replenishment (days)
[ ] Date of Last Soap Dispenser Inspection
[ ] Date of Last ABHR Dispenser Inspection
[ ] Details of Any Maintenance Issues Found During Inspection (e.g., leaks, malfunctions)
[ ] Condition of Soap Dispensers (Post-Inspection) (Excellent, Good, Fair, Poor)
[ ] Condition of ABHR Dispensers (Post-Inspection) (Excellent, Good, Fair, Poor)
[ ] Notes Regarding Supply Levels (e.g., consistently low stock, storage conditions)
[ ] Number of ABHR Dispensers Currently in Use

--- PATIENT/VISITOR HAND HYGIENE PROMOTION ---
[ ] Are hand hygiene stations clearly visible to patients/visitors? (Yes, No, Partially)
[ ] What types of promotional materials are available to patients/visitors regarding hand hygiene? (Posters, Brochures/Pamphlets, Digital displays/Videos, None)
[ ] Are instructions for hand hygiene prominently displayed? (Yes, No, Unsure)
[ ] Describe any patient/visitor feedback received regarding hand hygiene promotion (e.g., through surveys, complaints).
[ ] Estimated number of informational materials (posters, brochures, etc.) available for patient/visitor use.
[ ] Are staff actively encouraging hand hygiene among patients/visitors? (Always, Sometimes, Rarely, Never)
[ ] Upload a sample of a patient/visitor hand hygiene informational brochure/poster.

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