CEC Hand Hygiene Program

Hand Hygiene

In the hospital setting, the most common way for potentially harmful bacteria to transfer between patients is on the hands of health care workers. Improving the hand hygiene of health care workers is an integral strategy for infection control, and also the single most effective intervention to reduce the risk of health care associated infection.

Hand hygiene is a general term referring to any action of hand cleansing and includes:

  • Applying a waterless antimicrobial hand rub to the surface of the hands (e.g. alcohol-based hand rub), or
  • Washing hands with the use of a water and liquid soap, either non-antimicrobial or antimicrobial.
When performed correctly, hand hygiene results in a significant reduction of microorganisms on hands.


Working in conjunction with Hand Hygiene Australia, the CEC Hand Hygiene program provides training, education, promotional and reporting resources to raise awareness of the importance of hand hygiene and how everyone can play a role in reducing healthcare associated infections. The importance of a high rate of hand hygiene compliance among all health care workers, to prevent and control infections, is a priority.

Although the concept of hand hygiene is straightforward, there remain many challenges in further improving clinicians' hand hygiene performance.

The CEC is leading the implementation of the National Hand Hygiene Initiative (NHHI) within NSW Health facilities. Implementation of the NHHI has seen hand hygiene performance in NSW improve continuously and significantly from 2009 when the CEC began co-ordinating the program in NSW.

The 5 Moments for Hand Hygiene

Based on the 5 Moments for Hand Hygiene of the World Health Organization, the 5 moments are seen as the key opportunities to break the cycle of transmission.

5 Moments for Hand Hygiene
  1. Before touching a patient
  2. Before a procedure
  3. After a procedure or body fluid exposure risk
  4. After touching a patient
  5. After touching a patient's surroundings.

Hand Hygiene Considerations

Alcohol-based hand rub is the gold standard for hand hygiene practice in health care settings, as it:
  • Requires less time to use
  • Results in a significantly greater reduction in bacterial numbers than soap and water in many clinical situations
  • Causes less irritation to the skin
  • Can be made readily accessible to health care workers
  • Is more cost effective than antimicrobial soap
  • Can act as a visible cue to health care workers when placed at the point of care.

Hand washing with liquid soap and water is recommended for situations when hands are visibly soiled, or when caring for a patient with C. difficile or non-enveloped viruses such as norovirus, rotavirus, polio and hepatitis A. More information on alcohol-based hand rub is available from Hand Hygiene Australia.