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The date the observation occurred:
The time the observation started:
The time the observation ended:
The unit in which the observation occurred: CCU-PCU Emergency Maternity-Nursery Med-Surg Surgery
The role of the person observed: Nurse Patient Care Tech Nurse Practitioner Physician Associate Physician Nutrition Staff Therapist - PT OT ST Respiratory Therapist Phlebotomist Case Manager Radiology Tech Maintenance Housekeeping Information Systems Staff Student Other
Indication for the observation: Before touching patient Before aseptic procedure After touching patient After body fluid exposure After touching patient surroundings
Method of hand hygiene observed: Alcohol hand sanitizer Soap and water None - missed opportunity
Was hand hygiene performed correctly? Yes No
What intervention was taken? None Thanked for good hand hygiene Stopped and reminder given Reminder given after opportunity