National Hand Hygiene Auditor Training - FAQs – NHHI

Yes you can audit in single rooms, it may take a little longer than multi-bed rooms, but is certainly possible.  You must ensure you position yourself to be able to see all movement into and out of that room, the hand hygiene products and the care being given to the patient.

No.

Hand Hygiene Auditors must complete the Hand Hygiene Auditor Educator (HAE) training pathway in the NHHI LMS before training other auditors.  This ensures all HAEs have the requisite skills and knowledge to facilitate auditor training and the auditors they trained have standardised knowledge of how to audit hand hygiene practices.

See the Auditor Training and Validation web page for further information.

No. The Commission encourages facilities to rotate the wards completing the national audits so that every HCW in a healthcare facility learns about the importance of the program.

A Hospital is expected to collect data on all 'eligible' departments a minimum of once per year.

Please see the Guidelines for data submission - Hospitals for further information.

Once you have completed the Hand Hygiene Auditor Educator (HAE) training, you can train others to become Hand Hygiene Auditors and Hand Hygiene Auditor Educators. Revalidation Requirements for Hand Hygiene Auditors and Hand Hygiene Auditor Educators includes information about the validation requirements for existing Gold Standard Auditors.

Hand Hygiene Auditor Educators are responsible for

• Organising and running Hand Hygiene Auditor Practical Skills Training Sessions
• Organising and running Hand Hygiene Auditor Educator Facilitated Training Sessions and marking their learners’ Scenario-based Assessments after each training session.

The following resources required for facilitating training sessions are available in the NHHI Learning Management System (LMS).

For facilitating Hand Hygiene Auditor Practical Skills Training Sessions:

• Hand Hygiene Auditor (HA) Practical Skills Training Session - Presentation
• Hand Hygiene Auditor (HA) Practical Skills Training Session - Facilitation handbook
• Hand Hygiene Auditor (HA) Practical Skills Training Session - Evaluation survey template

For facilitating Hand Hygiene Auditor Educator Facilitated Training Session:

• Hand Hygiene Auditor Educator (HAE) Facilitated Training Session - Presentation
• Hand Hygiene Auditor (HAE) Educator Training Session - Facilitation handbook
• Hand Hygiene Auditor Educator (HAE) Facilitated Training Session - Evaluation survey template

The NHHI LMS Hand Hygiene Auditor Educator (HAE) – How to Guide provides instructions on how to use the training scheduling functions in the NHHI LMS.

You should read the relevant facilitation handbook and the “how to” guide before planning your training sessions.

To access the resources:

1. Log in to the NHHI LMS
2. Click on “Help/Documents” in the top right corner and scroll down to the new window showing Domain Files.

If you cannot access the resources, please submit a request for assistance using the NHHI Help Desk Contact Form.

For more information on the new auditor training pathways, please visit the Hand Hygiene Auditor Training and Hand Hygiene Auditor Educator Training webpages.

Your hand hygiene lead can advise each auditor about the expected number of moments to audit, per auditor.

Each organisation needs to submit data at minimum two times a year (national audit period 1 and 3) to the NHHI database and refer to their jurisdictional requirements when deciding whether to participate in national audit period 2. The number of Moments for each audit depends on the type and size of your facility.

For more information, including specific information for each type of health facility see:

Guideline for Data Submission - National Hand Hygiene Initiative

2024

Guide, user guide or guidelines

Please note: Health service organisations are able to collect and submit additional moments in excess of the recommended moments for each facility type. However, it is important to review the required data and consider its implications for targeted improvement strategies before collection of additional data.

HHCApp Region Administrators and Organisation Administrators can add local HCW types for their region/organisation. This allows them to collect data specifically on hand hygiene compliance for a particular healthcare worker group.

For more information see:

How to add healthcare worker (HCW) types – NHHI

2019

Guide, user guide or guidelines

No. As completion of the training pathway can take some time, it is important to prioritise selection of people from relevant clinical and non-clinical backgrounds, and people who will maintain their auditor status. 

Each auditor is required to meet the Auditor Validation Requirements in order to submit data to the NHHI HHCApp.

Hand Hygiene Program leads should have processes in place for regular liaison with auditors for their health service organisation.

Each jurisdiction is responsible for the sustainability of the program in their state.

You need to complete the Hand Hygiene Auditor Assessment each year.

For more information see: Revalidation Requirements for Hand Hygiene Auditors.

If you are trained to assist in an emergency situation, put your auditing equipment away and assist.  If you are not trained to assist, step aside and leave your auditing for another time, or move to another area to audit.  Patient safety always comes first.

A Hospital is expected to collect data on all eligible departments at least once per year.

Services other than hospitals are expected to collect data at least once per year for all areas where staff provide care to patients.

For more information see:  National Hand Hygiene – Audit Requirements.

The hand hygiene auditor role differs between organisations, depending on the experience and knowledge of the individual auditor. However, the Commission strongly recommends that auditors do not just audit, but are an integral part of the hand hygiene team. Suggested roles for an "auditor" are:

• Auditing
• Education
• Promotion

Assist with data review and planning of improvement strategies based on audit results.

Health service organisations rely on qualified and skilled auditors to undertake direct observational auditing to collect valid and reliable hand hygiene data.

Points to consider when selecting Hand Hygiene Auditors include:

• Capacity to complete the NHHI auditor training and conduct audits
• Acknowledgement and understanding of the safety and privacy concerns of patients and healthcare workers
• Ability to provide immediate feedback to healthcare workers for good hand hygiene practices and educate them on correct hand hygiene practices
• Recruiting from a range of health professions and clinical areas to promote widespread acceptance, ownership, and participation in activities to improve hand hygiene.

See:

Hand Hygiene Auditor Training User Guide

2024

Guide, user guide or guidelines

Hand hygiene auditors, including Hand Hygiene Auditors (HAs) and Hand Hygiene Auditor Educators (HAEs), need to complete the Hand Hygiene Auditor Assessment annually for auditor revalidation.

Hand hygiene auditors who do not maintain their auditor status:

• Will lose their auditor role in the HHCApp to enter audit data
• Must pass the Hand Hygiene Auditor Assessment to regain auditor status and access to the HHCApp.

HAEs who do not maintain their auditor status will also lose their HAE role and access to their sessions in the NHHI LMS.

To complete the Hand Hygiene Auditor Assessment:

1. Log in to the NHHI LMS
2. Select the Click here for Hand Hygiene Auditor and Hand Hygiene Auditor Educator training tile under Online Learning Module Categories
3. Select Hand Hygiene Auditor Assessment on the catalogue page
4. Select the Enrol button next to Hand Hygiene Auditor Assessment. If you are a Hand Hygiene Auditor Educator (HAE), you must enrol in the Hand Hygiene Auditor Assessment (HAE Refresher) (HAE) for your revalidation.

1. Log in to the NHHI LMS
2. Click on your name at the top right corner
3. Select “Personal Profile”
4. Select “Other Info.” and scroll down to “Learner Configuration” section. Your role will be listed under the “Learners Domain”.

Health service organisations rely on qualified and skilled Hand Hygiene Auditor Educators to train and support Hand Hygiene Auditors and Hand Hygiene Auditor Educators.

The NHHI recommends at least one Hand Hygiene Auditor Educator in each health service organisation to provide Hand Hygiene Auditor and Hand Hygiene Auditor Educator training.

Points to consider when selecting Hand Hygiene Auditor Educators include:

• A background as a clinical health professional
• Availability to provide auditor training
• Understanding of auditing, feedback, and education processes
• Acknowledgement and understanding of the safety and privacy concerns of patients and healthcare workers.

1. Log in to the NHHI LMS
2. Click on your name at the top right corner
3. Select “Personal Profile”
4. Select “Other Info.” and scroll down to “Learner Configuration” section. Your role will be listed under the “Learners Domain”.

A national training roster of Hand Hygiene Auditor Educators has been established in the NHHI LMS to support greater access to auditor training and encourage networking. It also supports Hand Hygiene Auditor Educators to meet revalidation requirements and maintain their educator status. Participation in the national roster is strongly encouraged. Your region/organisation’s preference for participating in the national training roster can be updated at any time.

If a health network or corporate group or individual organisation/facility participates in the national training roster, their Hand Hygiene Auditor Educators can enter information about training sessions they plan to deliver in the NHHI LMS training calendar. Learners can book these training sessions via the NHHI LMS, regardless of their location or the organisation that employs them.

Health networks, corporate groups and individual organisations/facilities that do not participate in the national training roster will need to provide in-house auditor training using the NHHI LMS hand hygiene auditor training resources. Learners from these groups can only enrol in local training sessions via the NHHI LMS.

No, a HHCApp auditor profile will be automatically created once a learner completes the Hand Hygiene Auditor (HA) Training Pathway in the National Hand Hygiene Initiative (NHHI) Learning Management System (LMS). If the learner has an existing user profile in the HHCApp, their profile will be assigned an Auditor role after completing the pathway.

The automatic process can only link the auditor to one organisation in the HHCApp. If the auditor conducts hand hygiene audits for multiple organisations, their Region/Group/Organisation Administrator needs to add them to all other organisations. See How to manage auditors for an organisation for instructions.