Good hand hygiene is one of the simplest and most effective ways to cut down transmittable viruses and infections in healthcare settings, but it isn’t always as simple as reminding staff they need to wash their hands before, during and after patient contact. There are several reasons that healthcare staff may not complete the hand washing procedure adequately; largely a lack of time and sometimes, a lack of awareness of the correct procedure. The 5 Moments for Hand Hygiene audit tool has been designed for use in acute hospitals and nursing homes by Hand Hygiene Australia. This has been developed as a reliable method of determining whether employees, including medical, auxiliary and allied health staff are carrying out the correct procedure at the correct times. 
Why use a hand hygiene observation tool? There have been a number of other hand washing audit tools used to determine hand hygiene in a healthcare setting (including monitoring how much liquid soap or other consumables are used), however the World Health Organisation recommends the observation method. Although auditing hand hygiene through an observation audit tool can be time consuming, it also allows the auditor to assess the hand hygiene behaviour, technique and compliance of staff for a general picture of effectiveness. The ‘5 Moments’ of monitoring HHA’s hand hygiene monitoring tool centres around five crucial moments of the staff/patient interaction:- Before touching a patient
- Prior to a procedure
- Immediately after a body fluid exposure risk
- After touching the patient, and
- After leaving the patient zone.
- Are wearing more than one plain (stoneless) ring on the fingers.
- Are wearing a watch on their wrist.
- Fail to pull up and keep sleeves away from the wrists.
- Having nail varnish present on the fingernails.
- Having false nails applied to the fingernails.
- Touch curtains at all throughout the audit, as these can often be contaminated and will mean the staff member should carry out hand washing once again.