Table 1.

Hand hygiene observation tool

Date:_____	Observed by:____________________
Staff title
Observations		Yes	No	Yes	No	Yes	No	Yes	No
Before clean and aseptic procedures, including medication preparation and prior to preparation, gown and glove for sterile procedures
After contact with blood, body fluids, secretions or excretions, mucous membranes, non-intact skin
After handling objects and devices such as soiled linen, trash, equipment
After removing gloves used for contact with body substances
Before patient contact
After patient contact
Before patient’s equipment contact
After patient’s equipment contact
Gloves used whenever potential for hand contact with blood/body fluids substance
Gloves removed immediately after use to avoid contaminating the environment