The 5 moments of hand disinfection

The model of „5 Moments“ (also known as "My 5 Moments for Hand Hygiene") is a globally recognized standard of the World Health Organization (WHO). It defines the crucial moments in everyday medical and nursing practice when hand disinfection is essential to stop the transmission of pathogens and prevent nosocomial infections.

The 5 indications at a glance

Detailed explanation of the indications

1. Before patient contact: Protects the patient from the transmission of pathogens that may be on the hands of staff (e.g., from shaking hands, taking pulses, or helping the patient stand up).
2. Before aseptic procedures: Protects the patient from pathogens that could be introduced into their own body (e.g., before inserting a venous catheter, administering injections, or changing dressings).
3. After contact with potentially infectious material: Protects staff and the environment from the spread of pathogens after completion of an activity with a risk of contamination (e.g. after drawing blood, emptying urine bags or handling secretions).
4. After patient contact: Protects staff and the hospital environment from patient germs (e.g., after repositioning, physical examination, or removing protective gloves).
5. After contact with the direct patient environment: Protects staff and the surrounding environment from pathogens that may be present on surfaces in the immediate vicinity of the patient (e.g., after touching the bedside table, the side of the bed, IV stands or bed linen, even if the patient themselves was not touched).

The concept of the patient zone

The WHO model strictly distinguishes between two areas to justify the logic of the 5 moments:

• The patient zone: This zone encompasses the patient as well as objects and surfaces in their immediate surroundings (e.g., the bed). Within this zone, the patient's germs may circulate (moments 1 and 2 ensure entry).
• The extended environment: This includes all areas outside the patient zone (other patients, corridors, ward staff). Moments 3, 4, and 5 prevent pathogens from being carried from the patient zone into this extended environment.

Significance in Germany

In Germany, this model forms the legal and professional basis for action. It is recommended by the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute (RKI) and is the foundation of the national "Clean Hands Campaign," which promotes compliance (Compliance) continuously measures and promotes these five moments in healthcare facilities.