Hand Hygiene

Health care associated infections (HCAI) are a major and growing issue in the quality and safety of health care, in both the hospital and community settings.

HCAIs have been nominated as a priority area by the Australian Commission on Safety and Quality in Health Care (ACSQHC). Improved healthcare worker hand hygiene (HH) is the highest priority area to reduce the risk of healthcare-associated infections. Reliable indicators of HH compliance are essential, and mechanisms for the wider implementation and monitoring are required.

The purpose of the National Hand Hygiene Initiative (NHHI) is to develop a national approach to improving HH and monitor its effectiveness.

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

  • Washing hands with the use of a water and soap or a soap solution, either non-antimicrobial or antimicrobial


  • Applying a waterless antimicrobial hand rub to the surface of the hands (e.g. alcohol-based hand rub).

When performed correctly, hand hygiene results in a reduction of microorganisms on hands.

The ‘Five Moments for Hand Hygiene’ have been identified as the critical times when hand hygiene should be performed.

St Andrew’s Hospital introduced the Hand Hygiene Programme in 2010. Three observational audits are undertaken per year of the ‘Five Moments for Hand Hygiene.’ All clinical areas within the hospital are included in the observational audits. There are 12 clinical areas with (at least) 100 moments per area audited per audit cycle (total 1200 moments), three times per year = 3600 moments for hand hygiene audited annually.

In 2018, St Andrew’s Hospital overall compliance rate was 83.9% which is above the national benchmark rate of 80% compared with the National (overall) rate of 84.8% and the Private national rate of 86.8% (includes peer private hospitals with similar numbers of inpatient beds).

Compliance Rate by Moment: Audit 1 2018

Comparison Rate versus National and Private Hospital average


Staph Aureus Bacteraemia

Staphylococcus aureus is a bacteria found in the respiratory tract and on the skin. It can live on a healthy person’s body without causing any harm but can cause infection if it enters the bloodstream.

Patients who develop bloodstream infections are more likely to suffer complications which result in a longer hospital stay, antibiotic treatment and an increased cost of hospitalisation. Serious infections may also result in death. Cases of Staphylococcus aureus bacteraemia (SAB) are monitored through infection control surveillance processes. Hand hygiene compliance rates and rates of SAB are measures of safety and quality of a healthcare facility. St Andrew’s Hospital monitors and reports these rates.