RAD - ELLIS MEDICAL LIBRARY

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This unit is a part of a Joint Commission hand hygiene research project.
As a part of this project I am questioning employees to better understand the barriers to hand washing.
I noticed that you did not wash your hands at room entry/exit. Please tell me why that happened?

JIT Coach Survey

* Indicates required field

JIT Coach *

Was this observed during rounds *

Yes No

What was the role of the health care professional you observed? *

RN = Nurse NA = Nursing Assistant MD = Doctor RT = Respiratory Therapy PT = Physical Therapy Diet = Dietary Technician Lab = Lab Technician HSK = House Keeping CM/SW = Case Mgmt/Social Worker Pharm = Pharmacist Rad = Radiology Tech Other

If other please specify their role: *

Was it an entry or an exit? *

Entry Exit

Possible contributing factors to not washing *

Dispenser Location Dispenser Empty Dispenser Broken Equipment Shared Hands Full of Supplies Hands Full of Meds Improper Use of Gloves Follow Person Entry or Exit Frequent Entry or Exit Admissions or Discharges Process Lack of Immediate Feedback Distracted or Forgot Perception that HH is not Required Perception of Skin Irritation Other

If other please specify: *

Submit

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