In reply: One moment doctor! Have you forgotten hand hygiene?

Abstract

Auditing the five moments of hand hygiene is potentially subjective, but auditor training is designed to ensure consistency between auditors within and between health care settings. Interpretative differences cannot explain consistent differences in compliance between professions. Moments sometimes, legitimately, coincide. The example given by Barnes is a double moment that would be audited as two correct moments if nothing were touched in between, as described in the Hand Hygiene Australia manual: “Typically, this occurs when moving directly from one patient to another without touching anything in between . . . a single hand hygiene action will cover two moments for HH [hand hygiene], as Moments 4 and 1 coincide”. Nevertheless, it is common, when moving between patients — even those immediately adjacent to each other — for us to touch objects, unconsciously; for example, the bed curtain, door handle, patient record, stethoscope, mobile phone, our nose, etc. Any of these objects can be contaminated with potential pathogens; failure to perform hand hygiene immediately before touching the next patient (Moment 1, the least often performed) can transmit pathogens more readily than most people realise.