Hand hygiene

Hand hygiene refers to the washing of hands or use of alcohol-based rubs. Good hand hygiene is a first-line defence against viruses and infections, such as COVID-19, influenza and Staphylococcus aureus bloodstream infections. This is especially important for hospital patients whose immune systems may already be weakened due to existing health conditions, or medical treatment they are undergoing, such as surgery.

How is hand hygiene measured in hospitals?

Hand hygiene amongst healthcare workers in hospitals is continuously monitored through hand hygiene audits, and data are reported for three consecutive audit periods a year for participating hospitals as part of the National Hand Hygiene Initiative (NHHI) coordinated by the Australian Commission on Safety and Quality in Health Care (ACSQHC). In the last audit period (November 2022 to March 2023), data are reported here for 619 public hospitals, which is over 90% of the 680 public hospitals listed on the Australian Government Department of Health’s list of Commonwealth Declared Hospitals as at 31 October 2022.

There are certain times when the risk of healthcare workers transmitting disease in hospitals is greater. Known as hand hygiene ‘moments’, these are:

• before touching a patient (Moment 1)
• before a procedure (Moment 2)
• after a procedure or body fluid exposure risk (Moment 3)
• after touching a patient (Moment 4)
• after touching a patient’s surroundings (Moment 5).

Hand hygiene compliance rates are calculated by dividing the number of compliant hand hygiene moments by the number of moments observed by auditors. Since 2017 the national benchmark for hand hygiene compliance has been 80%.

Hand hygiene compliance for each audit period is reported here for public hospitals at national, and individual-hospital levels, as well as by hand-hygiene moment and healthcare-worker group.

Hand hygiene in public hospitals 

The latest national-level data (from Audit period November 2022 to March 2023), show:

• the national hand hygiene compliance rate was 86% – above the 80% national benchmark
• hand hygiene for each of the 5 moments was also above the benchmark:
  1. before touching a patient: 83% 
  2. before a procedure: 91% 
  3. after a procedure or body fluid exposure risk: 93%
  4. after touching a patient: 89%
  5. after touching a patient’s surroundings: 81%.
• the highest rates of hand hygiene were among:
  1. dental professionals, for example, dentists’ compliance was 94%
  2. nurses and midwives: 89%.
• the following healthcare-worker groups did not meet the 80% benchmark:
  1. doctors (medical practitioners): 76%
  2. ambulance workers: 69%
  3. domestic staff (for example, food services, cleaning and maintenance workers): 76%.

The ACSQHC (2023) reports that for Audit period 1 of 2023 the highest rates of compliance were in departments for:

1. dentistry: 93%
2. renal care: 90%
3. neonatal care, mental health care, ambulatory care, oncology/haematology, palliative care (89%).

Emergency department (78%) was the only department type that did not been the 80% benchmark.

Hand hygiene in your hospital

The interactive table in the data visualisation above presents data on hand hygiene by participating public hospitals from 2010 onwards – see 'Hospitals' tab.

Data downloads

See the Admitted patient safety and quality page for more data downloads for hand hygiene in public hospitals from 2010 onwards.