In this review a user-centred approach to hand hygiene is introduced. It combines the results of the evidence-based risk analysis of healthcare-associated infections with research from ergonomics, social marketing, pedagogy, and communication science. In this model, the risk of pathogen transmission is based on a two-zone concept: the patient zone and the healthcare zone. The patient zone includes the intact skin of the patient and all inanimate surfaces that are touched by the patient or healthcare workers (HCWs). It is assumed to be rapidly contaminated with the patients flora. The healthcare zone, which goes beyond the patient zone and is considered to be contaminated with foreign microorganisms which might be potentially harmful to the patient. The two zones are helpful to deduce five specific indications for hand hygiene, termed as “5 Moments for Hand Hygiene”. The 5 Moments are: 1. BEFORE touching a patient 2. BEFORE aseptic procedures 3. AFTER body fluid exposure risk 4. AFTER touching a patient 5. AFTER touching patient surroundings. The model bridges the gap between scientific evidence for hand hygiene and its practical implementation.

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