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The 5 moments for hand hygiene

 

The World Health Organization (WHO) approach being implemented as part of the Hand Hygiene New Zealand programme identifies the following five moments for hand hygiene as critical to the prevention and control of infections. Please click on each moment for further information.

 

 

 

Moment 1: Before patient contact

Why: To protect the patient against harmful germs carried on your hands.
When:

Touching a patient in any way

  • Shaking hands, assisting a patient to move, allied health intervention

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, chest auscultation, abdominal palpation, applying ECG electrodes

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

Oral care and feeding

  • Feeding a patient, brushing teeth or dentures

Contact with a patient’s surroundings before, during and after any of the above

  • Bedside table, medical chart

Moment 2: Before a procedure

Why: To protect the patient against harmful germs, including the patient’s own, from entering his/her body.

When:

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

  • IV medication, NGT feeds, PEG feeds

Administration of medications where there is direct contact with mucous membranes

  • Eye drop instillation, suppository insertion

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

Moment 3: After a procedure or body fluid exposure risk

Why: To protect yourself and the healthcare environment from harmful patient germs.

When:

After any Moment 2

  • See Moment 2

After any potential body fluid exposure

  • Contact with a used urinary bottle/bedpan, 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

Moment 4: After patient contact

Why: To protect yourself and the healthcare environment from harmful patient germs.

When:

After any Moment 1 except where there has been a potential body fluids exposure

  • See Moment 1 and 2

Moment 5: After contact with patient surroundings

Why: To protect yourself and the healthcare environment from harmful patient germs.

When:

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, foot stool


5 moments for hand hygiene videos

The following video clips were designed by our colleagues at Hand Hygiene Australia to visibly demonstrate when each of the five moments for hand hygiene should occur.

Moment 1 - Before Touching a Patient

Moment 2 - Before a Procedure

Moment 3 - After a Procedure or Body Fluid Exposure Risk

Moment 4 - After Touching a Patient

Moment 5 - After Touching a Patient's Surroundings