Based on substantial evidence, the 5 Moments for Hand Hygiene are designed to minimise the risk of transmission of microorganisms between healthcare worker, the patient, and the environment.
My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.
This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.
This approach recommends health-care workers to clean their hands
- before touching a patient,
- before clean/aseptic procedures,
- after body fluid exposure/risk,
- after touching a patient, and
- after touching patient surroundings.
Moment 1 – Before Touching a Patient
video
WHEN:
Perform hand hygiene on entering the patient’s zone before touching the patient
WHY:
To protect the patient against acquiring harmful germs from the hands of the HCW
In detail:
| Touching a patient in any way | Shaking hands, Assisting a patient to move, Allied health interventions, Touching any medical device connected to the patient (eg. IV pump, IDC) |
| Any personal care activities | Bathing, Dressing, Brushing hair, Putting on personal aids such as glasses |
| Any non-invasive observations | Taking a pulse, Blood pressure, Oxygen saturation, Temperature, Chest auscultation, Abdominal palpation, Applying ECG electrodes, CTG |
| Any non-invasive treatment | Applying an oxygen mask or nasal cannula, Fitting slings/braces, Application of incontinence aids (including condom drainage) |
| Preparation and administration of oral medications | Oral medications, Nebulised medications |
| Oral care and feeding | Feeding a patient, Brushing teeth or dentures |
Moment 2 – Before a Procedure
WHEN:
Immediately before a procedure. Once hand hygiene has been performed, nothing else in the patient’s environment should be touched prior to the procedure starting.
WHY:
To protect the patient from potential pathogens (including their own) from entering their body during a procedure.
in detail:
| Insertion of a needle into a patient’s skin, or into an invasive medical device | Venipuncture, Blood glucose level, Arterial blood gas, Subcutaneous or Intramuscular injections, IV flush |
| Preparation and administration of any medications given via an invasive medical device, Preparation of a sterile field | IV medication, NGT feeds, PEG feeds, Baby NG feeds, Dressing trolley set up |
| Administration of medications where there is direct contact with mucous membranes | Eye drop instillation, Suppository insertion, Vaginal pessary |
| Insertion of, or disruption to, the circuit of an invasive medical device | Procedures involving the following:
ETT, Tracheostomy, Nasopharyngeal airways, Suctioning of airways, Urinary catheter, Colostomy/ileostomy, Vascular access systems, Invasive monitoring devices, Wound drains, PEG tubes, NGT, Secretion aspiration |
| Any assessment, treatment and patient care where contact is made with non-intact skin or mucous membranes. | Wound dressings, Burns dressings, Surgical procedures, Digital rectal examination, invasive obstetric and gynaecological examinations and procedures, Digital assessment of newborn palate |
Moment 3 – After a Procedure or Body Fluid Exposure Risk
WHEN:
Hand hygiene immediately after a procedure or body fluid exposure risk as hands could be contaminated with body fluid.
Even if you have had gloves on you should still perform hand hygiene after removing them as gloves are not always a complete impermeable barrier. Hands may also have been contaminated in teh process of removing the gloves.
WHY:
To protect yourself and the healthcare surroundings from becoming contaminated with potential pathogens.
in detail:
| After any Moment 2 | See Moment 2 |
| After any potential body fluid exposure | Contact with a used urinary bottle / bedpan, Contact with sputum either directly or indirectly via a cup or tissue, Contact with used specimen jars / pathology samples, Cleaning dentures, Cleaning spills of urine, faeces or vomit from patient surroundings, After touching the outside of a drain
Contact with any of the following: Blood, Saliva, Mucous, Semen, Tears, Wax, Breast milk, Colostrum Urine, Faeces, Vomitus, Pleural fluid, Cerebrospinal fluid, Ascites fluid, Organic body samples eg. Biopsy samples, Cell samples, Lochia, Meconium, Pus, Bone Marrow, Bile. |
Moment 4 – After Touching a Patient
WHEN:
Hand hygiene after touching a patient. Perform hand hygiene before you leave the patient zone.
WHY:
To protect yourself and the healthcare surroundings from becoming contaminated with potential pathogens.
Moment 5 – After Touching a Patient’s Surroundings
WHen:
Hand hygiene after touching a patient’s surroundings even when the patient has not been touched.
Always hand hygiene before leaving the room.
WHY:
To protect yourself and the healthcare surroundings from becoming contaminated with microorganisms.
in detail:
| After touching the patient’s immediate surroundings when the patient has not been touched. | Patient surroundings include: Bed, Bedrails, Linen, Table, Bedside chart, Bedside locker, Call bell/TV remote control, Light switches, Personal belongings (including books, Mobility aids), Chair, Footstool, Monkey bar |
Reference: https://www.hha.org.au/hand-hygiene/5-moments-for-hand-hygiene/moment-5