Nurse Learning Hub
Healthcare-associated infections are among the most common complications of hospital care. Hand hygiene is the most effective single measure to prevent them, and in Australia it is promoted through the National Hand Hygiene Initiative run by the Australian Commission on Safety and Quality in Health Care. The Preventing and Controlling Infections Standard (NSQHS Standard 3) requires services to have a hand hygiene program.
The 5 Moments
| Moment | When | Why | Example |
|---|---|---|---|
| 1 | Before touching a patient | Protect the patient from germs on your hands | Before taking observations or helping a patient move |
| 2 | Before a procedure | Protect the patient from germs entering their body | Before IV cannula care, wound dressing, inserting a catheter |
| 3 | After a procedure or body fluid exposure risk | Protect yourself and the environment | After emptying a urinary drainage bag, after removing gloves |
| 4 | After touching a patient | Protect yourself and the environment | After a physical assessment or handshake |
| 5 | After touching a patient's surroundings | Protect yourself and the environment | After adjusting the bed, touching the bedside table or IV pump |
Rub or wash?
- Alcohol-based hand rub is the preferred method for most moments – it is faster and more effective against most organisms. Rub all surfaces until dry (about 20–30 seconds).
- Soap and water when hands are visibly soiled, and when caring for patients with infections such as Clostridioides difficile or norovirus, as per local policy.
Gloves are not a substitute
Gloves can have micro-holes and hands become contaminated when gloves are removed. Perform hand hygiene before putting on gloves when a procedure requires it, and always after removing them. Change gloves between patients and between dirty and clean tasks on the same patient.
Common pitfalls
- Forgetting Moment 5 after touching only the environment.
- Touching the patient zone again (curtains, phone) between hand hygiene and the procedure.
- Wearing jewellery, long or artificial nails that prevent effective hand hygiene.
- Skipping hand care – dermatitis makes hand hygiene painful and less effective. Use the moisturiser provided.
CPD idea: many health services provide the National Hand Hygiene Initiative online learning module. Completing it and reflecting on one change to your practice is a quick, relevant CPD entry.
Sources and further reading
- ACSQHC – National Hand Hygiene Initiative
- World Health Organization – Hand hygiene
- NHMRC – Australian Guidelines for the Prevention and Control of Infection in Healthcare
- Australian Commission on Safety and Quality in Health Care – NSQHS Standards
Reviewed October 2026. This article is general educational information, not clinical or legal advice. Standards and local policies change – always check the current version from the source and follow your organisation's procedures.