The patient care situations that involve a risk of infection are closely linked to the surroundings of the respective patient. To disinfect the hands at the right moment, it is therefore important to recognize the different zones within the patient surroundings.

They are a milestone for compliance: the 5 Moments for Hand Hygiene. It is not without reason that the German Commission for Hospital Hygiene and Infection Prevention (KRINKO) has embedded the “5 Moments” concept in their new recommendations. Hand hygiene has become much easier since the many individual indications were pooled in five indication groups. For employees, it is easier to recognize the right moment for hand disinfection within their working processes. And the compliance increases.


The 5 Moments were developed on the basis of a spatial two-zone concept, which was derived from movement patterns and tasks of healthcare workers as well as the associated risks of pathogen transmission in these two zones. Since then, a distinction has been made between the patient zone and the health care zone.

Patient zone

This zone contains the immediate surroundings of the patient. This includes all surfaces that are touched by the patient, such as bed linen and bed frames. Surfaces that are often touched by the patient or by caregivers such as bed frames, bedside tables or monitors also belong to the patient zone.

Healthcare zone

This zone comprises all areas outside the patient zone, e.g. the complete environment of the healthcare facility.

And also the principle of the point of care is closely linked to the 5 Moments model and the two-zone concept:

Point of care

According to WHO, the point of care is the place where three elements come together: the patient, the healthcare worker, and the care or treatment which involves contact with the patient or her/his immediate surroundings. This concept also embraces the need to safely perform hand hygiene in the necessary moments. This in turn requires hand disinfectants to be easily accessible directly at the point of care.

Know the difference

At Sani nudge, we have spend a long time research how to automatically measure the difference between a healthcare worker being in patient contact or not. This is important as we do not want to punish careful caregivers for focusing on only touching the patient when it is needed. These caregivers tend to keep a natural distance to the patient when delivering a message while not being in patient contact. This relates to the two-zone concept and is why we at Sani nudge have adapted this concept into our automated hand hygiene monitoring system. Our sensors auto-calibrate to always distinguish between a caregiver being in the patient or health care zone.  This way we can precisely tell if a caregiver is compliant or not.