ALM HAND HYGIENE AUDIT

HAND HYGIENE AUDIT
Our goal is to help you document required audits in a clear, consistent, and survey-ready way. As part of the facility's Infection Control Quality program, please observe the care provider for hand hygiene compliance and document your findings below. Complete one form for each care provider observed.

How to use this form:
- Enter the date of the audit
- Select the type of care provider observed
- Complete the observation section based on the activity observed
- Use the checkboxes to indicate activities observed
After submission:
- A copy of your completed report will be emailed to the address provided
- Use the report as part of your facility’s quality documentation
- Need to make edits? Your email will contain a link to come back to your report - You will receive a new report after re-submission
Questions?
- If you need assistance or have questions, contact support@almss.com
Name of Facility:*
Observer's Name:*

First NameLast Name
Email address for report delivery:*

Confirmation EmailPlease confirm email address to ensure proper report delivery
Please enter your access code to access the form:*
If you do not have an access code, please contact support at 770-325-0140, for assistance.** Please note: passcode is case-sensitive **

Rows	Not Observed	YES: Followed Proper Hand Hygiene	NO: Did NOT follow proper Hand Hygiene
Prior to patient contact
Prior to aseptic or invasive procedures
After body fluid exposure risk
After patient contact
After touching patient surroundings
Prior to donning gloves
After removing gloves

Rows	Yes	No	N/A
Was there a sufficient supply of alcohol-based hand sanitizer?
Was there a sufficient supply of soap at handwashing station(s)?
Was there a sufficient supply of paper towels at handwashing station(s)?
Was there visible and easy access to hand washing sink(s) or hand sanitizer?