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Criterion Links: 6.1.4
PI-01-007
Infection Control
target Zone
Hospital-wide Direct Observation Hand Hygiene Compliance Rate
Hand hygiene is the single most effective intervention to reduce healthcare-associated infections.
Target Threshold85%
Latest Result88%
SIQ Trigger Condition Met
PI-01-007Critical breach zone for 2 or more consecutive periods
Consecutive periods in breach zone: Q3-25 (74%) and Q4-25 (72%).
PI-01-007
6 recorded periodsEntered (filled)
Imported (hollow)
Breach point (enlarged)
Target Breach threshold Adoption date (8 Dec 2025)
Indicator Tracking Register & Readings
Historical numerator and denominator logs. Results are derived mathematically on every render.
| Period | Numerator | Denominator | Result | Target | Zone | Action Taken | Source |
|---|---|---|---|---|---|---|---|
| Q4 2024 | 180 | 200 | 90 | 85% | target | — | imported |
| Q1 2025 | 178 | 200 | 89 | 85% | target | — | imported |
| Q2 2025 | 174 | 200 | 87 | 85% | target | — | imported |
| Q3-25 | 148 | 200 | 74 | 85% | breach | Action plan 30-day intervention initiated | imported |
| Q4-25 | 144 | 200 | 72 | 85% | breach | Follow-up monitoring under active action plan | imported |
| Q1 2026 | 176 | 200 | 88 | 85% | target | — | entered |