According to the Leapfrog Group, the Leapfrog hand hygiene standard focuses on adherence to “best practice” hand hygiene practices. It was developed by a national Hand Hygiene Expert Panel and adapted from the World Health Organization’s “Hand Hygiene Self-Assessment Framework.”

Leapfrog’s hand hygiene standard includes five domains. Hospitals receive a score based on their performance on these 5 domains of hand hygiene. They include:

  • Monitoring (Electronic and/or Direct Observation): Including assessing compliance with hand hygiene technique
  • Feedback: Including evaluations and use of compliance data
  • Training and Education: Including demonstrations of technique
  • Infrastructure: Including hand sanitizer dispensers
  • Culture: Including leadership buy-in

The standard encourages facilities to adopt a multimodal approach to hand hygiene. Each hospital achieving the leapfrog hand hygiene standard must meet all elements for both the Monitoring and Feedback domains, as well as 2 of the 3 remaining domains (Training & Education, Infrastructure, and Culture).

The Role of SureWash’s Hand Hygiene Training technology and meeting the Leapfrog Hand Hygiene Standards

The role of SureWash in helping you achieve the Leapfrog hand hygiene standard is primarily in the Training & Education domain. However, the system can also assist with Culture & Feedback. In addition, SureWash has been proven to help improve compliance levels as staff are encouraged to participate in learning and therefore become more confident and aware.

Training & Education

SureWash delivers hand hygiene technique training to the World Health Organization (WHO) protocol. To support this practical learning, the SureWash technology also facilitates the delivery of lessons and quizzes. It can provide initial training at the time of onboarding and also refresher training. Medical staff, technicians, and environmental services personnel can all use the SureWash technology. In addition, a reporting function is available to highlight when refresher training is due.

SureWash is validated in multiple published papers as an assessment tool. As part of the standard, Leapfrog requires a physical demonstration using soap or gel by a human observer. However, as hand hygiene is a psychomotor skill, you cannot teach the technique in a single classroom session. SureWash automates the learning so that staff are competent to pass the physical assessment as the technique is part of their muscle memory. This saves significant time for both the observer and trainer. Annual training does not require physical observation of the technique using a human observer and therefore, SureWash can fulfil the entire function.

SureWash also facilitates education on broader IPC topics. For example, Leapfrog requires education on WHO’s 5 Moments for Hand Hygiene, glove use, hand hygiene monitoring and more. Facilities can either use SureWash’s lesson and quiz content developed with clinical experts to meet these requirements, or you can upload your own content.


A critical part of the Leapfrog standard is to provide feedback on hand hygiene compliance data to those who touch patients and/or touch items that will be used by patients, and to hospital or ASC leadership. It is also important to use the hand hygiene compliance data for creating action plans and to improve hand hygiene performance.

Through the SureWash reporting suite, all hand hygiene training data is available at the click of a button. Training data is available by department or down to individual level on demand. Administrators can track users learning progress and view the learning curve towards level 5 compliance. You can also identify gaps in knowledge through the reports which then highlights the areas in need of re-training. All training reports are available to download in PDF or Excel format to give to senior administrative leadership, physician leadership, and nursing leadership. You can also filter these reports by date to identify trends over time.


SureWash technology helps improve hand hygiene culture by empowering staff and providing interactive and accessible education. Adopting SureWash demonstrates a strong commitment to hand hygiene training. When senior management train on SureWash themselves and publish aggregated reports, it also demonstrates to staff their commitment to improving hand hygiene.
In addition, to remind healthcare workers to perform hand hygiene, you can use SureWash as a promotional device by customizing SureWash attract loops with your facilities call-to-action. Also, patients and visitors can use the SureWash app to learn about the importance of hand hygiene, encouraging them to remind healthcare workers to perform hand hygiene.

Monitoring (Electronic and/or Direct Observation)

SureWash can also support you with certain elements of Monitoring and Direct Monitoring – Direct Observation. For healthcare workers to be compliant with the 5 Moments of hand hygiene, the starting point is to deliver hand hygiene training so that staff are prepared for their direct observation. SureWash offers a complete solution for educating healthcare workers about the how, why, and when of hand hygiene. You can also use SureWash for both the initial and recurrent training and validation of hand hygiene compliance observers. For example, the Infection Control Network Africa (ICAN) Train-The-Trainer program uses the SureWash technology platform. It supports both their in-person education and the cascade of training to other staff in the facility. A study on the use of SureWash to support their training is available here.

For our full document on how SureWash helps you achieve the Leapfrog hand hygiene standard, click here. This document, breaks down the Leapfrog requirements into a table, explaining how SureWash can help.


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If you have any questions on using SureWash to help you achieve the Leapfrog Hand Hygiene standards, please contact us below: