About Hand Cleaning / Hand Hygiene

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Hand hygiene refers to removing or killing microorganisms on the hands and is one of the most effective measures to prevent the spread of infections. There are serious health implications and financial costs associated with healthcare associated infections (HAIs), which makes hand hygiene a priority.

HandHygieneResourcesHANDSHand hygiene is a simple and effective way of preventing the transmission of infections. Because microorganisms can be spread by anyone, hand hygiene is everybody’s responsibility: staff, patients, residents, visitors, and volunteers.

Either alcohol based hand rub (ABHR, also known as hand sanitizer) or soap and warm water are accepted methods of hand hygiene:

  • soap and water is preferred if you have contact with a patient who is known to have C. difficile or norovirus, or if your hands are visibly soiled
  • otherwise, ABHR is as effective as soap and water – and will not dry out your skin.

Because microorganisms can be spread by anyone, maintaining good hand hygiene is everybody’s responsibility: staff, patients, residents, visitors, and volunteers. Healthcare providers, including nursing staff, physicians, clinical support services, and others such as housekeeping staff, should lead by example in maintaining good hand hygiene. Wearing gloves is not a substitute for hand cleaning.

Patients, volunteers, and visitors should be reminded of the importance of hand hygiene, especially before eating or preparing food, after using the toilet or other personal hygiene activities, before leaving their homes for public areas, and when returning home from public places. You can read more about hand hygiene including glove use and hand care, at picnet.ca/guidelines/hand-hygiene, under About Hand Hygiene.

Provincial Hand Hygiene Program

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There is increasing awareness of the importance of hand hygiene (HH), not only to protect patients but also to protect the health of health care providers. In response to an Office of the Auditor General review on hand hygiene programs in healthcare and with the support of the Ministry of Health and the BC Health Operations Council, the Provincial Hand Hygiene Working Group (PHHWG) was formed with representatives from each of the regional health authorities, the Ministry of Health, and the Provincial Infection Control Network of BC (PICNet).


To develop province-wide hand hygiene program for the health authorities and assist in its implementation for the individual health authorities.


To create a comprehensive provincial program that will improve and sustain hand hygiene culture, in order to decrease the transmission of health care-associated infections in BC health care facilities.

Compliance Auditing

Provincial auditing of hand hygiene compliance in acute care facilities commenced in 2012 and expanded to include residential care facilities in 2014. Every quarter, trained auditors observe a sample of healthcare providers, and record whether they clean their hands at the appropriate times, i.e. before and after touching a patient or the patient’s immediate environment (e.g., changing bed linen, touching a bed rail, clearing a bedside table, etc.). The percentage score reports how often healthcare providers clean their hands when required to do so. The methods of auditing may vary from facility to facility; some do self auditing, while others have dedicated auditors. The compliance data are sent quarterly to PICNet, and compiled into reports, which are posted publicly.

Hand Cleaning Compliance (Auditing) Reports

Latest Quarterly Report: Hand Cleaning Compliance: Q4 of 2018-2019

Access the most recent annual report, and to read more about the auditing process

Annual Report:

Annual Surveillance Report for the fiscal year 2017-2018

Reports on provincial hand cleaning compliance are published quarterly. Data are collected by all the health authorities, and submitted to PICNet for analysis and reporting. The reports are reviewed by the Provincial Hand Hygiene Working Group (PHHWG).

Audits for hand hygiene compliance focus on before and after contact with either the patient or the patient’s environment. Each health authority audits their healthcare workers’ hand hygiene slightly differently, depending on the resources available; however, they all collect the same basic information.

The compliance rate is derived by dividing the number of compliant hand hygiene opportunities (before and after contact with the patient or patient environment) by the number of total hand hygiene opportunities (before and after contact with the patient or patient environment).

% = compliant opportunities / total opportunities


Other resources and links

You can find the Provincial Hand Hygiene Guidelines, as well as other resources, under the Guidelines and Toolkits – Hand Hygiene menu.