The 'My five moments for hand hygiene' concept for the overcrowded setting in resource-limited healthcare systems

J Hosp Infect. 2015 Oct;91(2):95-9. doi: 10.1016/j.jhin.2015.04.011. Epub 2015 May 1.


Hand hygiene is a core activity of patient safety for the prevention of healthcare-associated infections (HCAIs). To standardize hand hygiene practices globally the World Health Organization (WHO) released Guidelines on Hand Hygiene in Health Care and introduced the 'My five moments for hand hygiene' concept to define indications for hand hygiene rooted in an evidence-based model for transmission of micro-organisms by healthcare workers' (HCWs) hands. Central to the concept is the division of the healthcare environment into two geographical care zones, the patient zone and the healthcare zone, that requires the HCW to comply with specific hand hygiene moments. In resource-limited, overcrowded healthcare settings inadequate or no spatial separation between beds occurs frequently. These conditions challenge the HCW's ability to visualize and delineate patient zones. The 'My five moments for hand hygiene' concept has been adapted for these conditions with the aim of assisting hand hygiene educators, auditors, and HCWs to minimize ambiguity regarding shared patient zones and achieve the ultimate goal set by the WHO Guidelines--the reduction of infectious risks.

Keywords: Alcohol-based hand rub; Hand hygiene; Healthcare workers; Healthcare-associated infections; My five moments for hand hygiene; Overcrowding; Patient zone.

Publication types

  • Review

MeSH terms

  • Cross Infection / prevention & control
  • Crowding*
  • Delivery of Health Care*
  • Disease Transmission, Infectious / prevention & control
  • Hand Hygiene / methods*
  • Humans
  • Infection Control / methods*
  • Patient Safety