Auditing Strategies to Improve Infection Prevention Processes in Nursing Homes

Nursing homes can conduct observational audits to support increased compliance with infection prevention practices, including hand hygiene and use of personal protective equipment.

Observational Audits

Observational audits occur while staff are in the work environment and help obtain accurate compliance rates and process failures. The resources below provide additional information on observational audits and how to conduct them.

• Competency Check vs. Observational Audit: Validate Nursing Home Staff Performance to Improve Infection Prevention Processes for COVID-19 (PDF, 475 KB)
  This comparison tool helps skilled nursing facilities differentiate between competency validation for regulatory compliance, and observational auditing for Quality Assurance Performance Improvement activities.
• Observational Audits: A Pathway to Improving Infection Prevention and Preventing the Spread of COVID-19 (PDF, 530 KB)
  This step-by-step guide helps skilled nursing facilities establish a process for observational auditing to provide a true assessment of performance in the actual work environment and helps facilities collect data that can be used to support improvements in infection prevention.

Hand Hygiene Observational Audits Data Tracking Tool and User Guide

The Hand Hygiene Observational Audit Tracking Tool and companion User Guide provide skilled nursing facilities an analytic tool to compile hand hygiene observational audit data to identify performance patterns and target improvement.

• Hand Hygiene Observational Audit Tracking Tool (Excel, 476.2 KB)  
  This pre-programmed Excel workbook compiles hand hygiene observational data by individual, shift, position, location, and department to help staff regularly review opportunities for hand hygiene performance improvement. This tracking tool is used in conjunction with the Hand Hygiene Observational Audit Tracking Tool User Guide (PDF).
  Persons with disabilities experiencing problems accessing the content in the Excel file should contact Karen Fleming-Michael (301-427-1798, karen.flemingmichael@ahrq.hhs.gov) and ask for assistance.
• Hand Hygiene Observational Audit Tracking Tool User Guide (PDF, 1.2 MB)
  This guide gives nursing home staff detailed, step-by-step instructions with visuals to record, analyze, and review observational audit data using the Hand Hygiene Observational Audit Tracking Tool (Excel).

Personal Protective Equipment COVID-19 Observational Audit Data Tracking Tool and User Guide

The Personal Protective Equipment COVID-19 Observational Audit Data Tracking Tool and User Guide help nursing homes identify performance patterns and target improvement more readily with an analytic tool to compile personal protective equipment (PPE) audit data.

• Personal Protective Equipment (PPE) COVID-19 Observational Audit Tracking Tool  (Excel, 634.2 KB)
  This pre-programmed Excel workbook compiles PPE audit data by individual, shift, position, location, and department, to help staff regularly review opportunities for improvement in donning and removing PPE.
  Persons with disabilities experiencing problems accessing the content in the Excel file should contact Karen Fleming-Michael (301-427-1798, karen.flemingmichael@ahrq.hhs.gov) and ask for assistance.
• Personal Protective Equipment (PPE) COVID-19 Observational Audit Tracking Tool User Guide  (PDF, 1 MB)
  This guide for nursing home staff provides detailed, step-by-step instructions with visuals to record, analyze, and review observational audit data using the Personal Protective Equipment (PPE) COVID-19 Observational Audit Tracking Tool (Excel).