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DebMed Blog: Healthcare Hygiene Matters

5 Moments vs. 2 Moments. What is enough when it comes to hand hygiene?

Posted by DebMed on Dec 10, 2015 9:30:00 AM

Do more with less. Boost efficiency. Streamline processes. Enhance productivity. Healthcare professionals routinely hear these imperatives/mandates from clinical supervisors,  managers and executives.    

The approach makes sense as healthcare organizations strive to upgrade, consolidate and automate clinical, operational and financial processes.  For example, simplifying and reducing steps by going from paper-based files to electronic medical and health records makes sense. Going from the multi-step process of manual scheduling to online appointment scheduling and confirmation makes sense.

On the other hand, trying to streamline or simplify healthcare’s hand hygiene compliance routine is not the way to go.  And yet, many healthcare professionals still employ the “in and out” method of hand hygiene, washing their hands at just two of the five moments for hand hygiene.  

WHO 5 Moments For Hand Hygiene

Based on evidence and field testing, the World Health Organization (WHO) has defined key moments—known as the Five Moments for Hand Hygiene—when healthcare professionals should wash or sanitize their hands.  Adhering to the higher clinical standards inherent in the supports healthcare professionals in the achievement of two critical goals:  

  • Reduce the risk of contamination at critical moments of patient care
  • Ensure the safety, well-being and good health of patients, visitors and staff

Following the Five Moments is a journey, not a destination.  Adherence demands ongoing orientation, education, and training along with recognition and reward.  But if healthcare professionals properly implement the Five Moments, they can prevent and manage dangerous and costly healthcare crises—from U.S.-based outbreaks connected to

Healthcare professionals must understand that each step within the Five Moments serves a vital function: 

One:  Clean your hands before touching a patient or the patient’s immediate surroundings.   Why? Protect the patient from acquiring germs that might be on your hands.  Clean your hands prior to personal care activities like bathing, dressing, brushing and oral care, as well as non-invasive observations (taking vital signs) and treatments.     

Two:  Clean your hands before a procedure.  Why?  Protect the patient from harmful germs, including their own, that could enter the body during procedures like needle insertions, medication administration and connecting to invasive medical devices like EEGs.  

Three:   Clean your hands after a procedure or body fluid exposure. Why?   Protect yourself and the patient’s surroundings from harmful patient germs generated via contact with fluids like blood, saliva, mucous, semen, tears or urine.   

Four:   Clean your hands after touching a patient.   Why?  Protect yourself and the immediate environment from harmful patient germs.  After you touch a patient, you could have microorganisms on your hands that would get passed on to other patients.   

Five: Clean your hands after touching a patient’s surroundings. Why?  Protect yourself and the immediate surroundings from harmful patient germs.

What happens if healthcare professionals practice hand hygiene only at entry and exit of the patient room instead of at all five moments?  Patients, visitors and staff go at risk for contaminating themselves during patient or patient-environment interactions.  And consider this - perhaps not even the five moments are adequate enough for ensuring hand hygiene compliance.  The debate continues, with some experts arguing for a sixth moment of hand hygiene.

Healthcare professionals must realize that hand hygiene compliance is the single most effective intervention for reducing the risk of HAIs in hospitals and other settings along the continuum of care.  Review any hand hygiene compliance recommendations by posing the following questions:

  • Is the process comprehensive? Does it apply to all care settings and healthcare professions?
  • Can healthcare professionals easily remember, repeat and adhere to the process? Can they explain and share the process with patients, family members and fellow clinicians?     
  • Can the healthcare organization monitor, measure and evaluate process compliance across the enterprise and in a variety of care settings?

If you look before you leap, the Five Moments for Hand Hygiene will emerge as the safest standard for safeguarding patients, visitors and providers.   

By adhering to the WHO Five Moments for Hand Hygiene, supported by  , healthcare professionals can help ensure the safety, health and well-being of patients, consumers, family members and clinicians. They can also safeguard an organization’s image, reputation and standing in ranking and rating systems. See our four Hand Hygiene Tips!


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About the blog

The DebMed blog is the go-to source for hand hygiene and infection prevention related discussions occurring in the healthcare industry. Join the conversation! All readers are invited to comment, share stories and information, and post articles of interest.

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