How Can I Involve Staff More Into Hand Hygiene?



According to the WHO, the best way, to improve patient safety and especially hand hygiene is to develop a multimodal strategy; applying several interventions in an integrated way [1]. A multimodal strategy needs to be tailored to the actual hospital, considering local structural and cultural aspects. As a good combination differs from hospitals to hospitals, most of the effective multimodal strategies have been built from the same cornerstones [2]. If you plan to develop your own hand hygiene improvement strategy, consider to



  • Make hand hygiene product available everywhere, especially at the point of care. Use of personal handrub bottles can also be an option.
  • Track usage of hand hygiene supplies (ABHR)
  • Keep on eye on ward occupancy and workload
  • Educate frontline healthcare workers (HCW)
  • Organize training not only for HCW but also for managers
  • Provide additional training materials
  • Use guidelines in combination with education/training
  • Monitor hand hygiene compliance and technique
  • Set compliance goals and provide feedback
  • Routinely screen for antimicrobial resistant organisms
  • Run active HAI (healthcare-associated infections) surveillance
  • Standardize audits and run it regularly
  • Place reminders (e.g. posters)
  • Find role models and involve them
  • Engage all relevant stakeholders
  • Involve patients, and their families, if applicable
  • Apply positive reinforcement; e.g. financial incentives or other reward based on performance
  • Promote safety culture
  • Regularly publish and promote latest results of the program



A good combination of the above interventions can induce hand hygiene behavioural change. Keep in mind, that implementation of such a complex multimodal program requires at least 5 years of commitment [1].