Observer: ________________________________________________ Date: ________________ Time: _________ Dept: ________________ HH resources: _____________________ | |||||||||||||
Moment/Method | DOCTOR | NURSE | PATIENT | STAFF | STUDENT | VISITOR | |||||||
YES | NO | YES | NO | YES | NO | YES | NO | YES | NO | YES | NO | ||
BEFORE touching a patient | WASH | ||||||||||||
RUB | |||||||||||||
BEFORE “Clean” procedure | WASH | ||||||||||||
RUB | |||||||||||||
AFTER PATIENT body fluid exposure risk | WASH | ||||||||||||
RUB | |||||||||||||
AFTER PERSONAL body fluid exposure risk | WASH | ||||||||||||
RUB | |||||||||||||
AFTER touching a patient | WASH | ||||||||||||
RUB | |||||||||||||
AFTER touching patient surroundings | WASH | ||||||||||||
RUB |