Thank you for participating in our research.


Data from this form will be analysed to generate important information regarding the material and infrastructure requirements to support the practice of hand hygiene at the ‘point of care’ in your hospital. Hand hygiene is fundamental to Patient Safety. Please ensure that you complete the form correctly.  Input your responses in the boxes adjacent to each question. It should only take a few minutes to complete the form.


Below you will find the questionnaire in a variety of formats for your convenience.


You can download the pdf for completion by hand - either post this or scan and email


You can download a digital copy in Word format - complete the form and return via email


You can complete the form online and press submit


Adobe Acrobat document [473.0 KB]
Microsoft Word document [126.6 KB]



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