Hand hygiene is the most effective way to prevent the spread of healthcare-associated infections. Yet, nearly 1 in 4 hospitals fail to fully comply with hand hygiene guidelines. This results in an increase in antibiotic resistance and fiscal penalties.

There is a variety of reasons for this number. According to studies, the most common causes of poor hand hygiene are ineffective placement of dispensers or sinks, poor collection of hand hygiene compliance data, and lack of accountability. Insufficient education, poor promotion of hand hygiene in the safety culture, and plain lapse in memory can also be a factor.

Poor compliance to hand hygiene practices in a medical facility can be caused by one or a couple of these factors. Identifying the cause is the first step in developing a good solution to this problem. Then, use the information to develop a positive program, leadership commitment, and team work to ensure the success of your hospital’s hand hygiene and infection prevention systems. Some recommendations to improve compliance are listed below.

1. Motivate healthcare professionals to act

Make the pros and cons of the program more tangible in order to encourage everyone in your hospital to comply. Explain how non-compliance leads to infections that may get them ill or get passed to their patients. Provide specific examples and see to it that the caregivers understand the gravity of the situation. Make healthcare professionals more accountable and let them know that the simple act of hand hygiene makes a big difference in delivering quality care.

2. Increase evidence points

Ramp up your educational campaign and put up instructive posters, signage, pocket cards, and brochures in strategic locations throughout the hospital. This will help in modifying behavior as visual reminders are a great tool to boost adherence. According to a study in Health Psychology, just posting an image of a man’s eyes over the sanitizer dispenser increased compliance by 33%.

3. Let directives come from the top down

Employees tend to participate more if they see that the administration is committed to directives. Compliance increases if administrators and seniors are vocal advocates of the program.

4. Develop an ongoing monitoring program

First, establish a monitoring and feedback system on infection rates. Mitigating infections should be the priority around the hospital and this can be done through effective monitoring of endemic and emerging drug resistant pathogens. Second, establish processes or systems that track compliance. A number of effective measures can be used, including direct observation, measuring product use, and electronic monitoring.

Direct observation involves watching the actual actions of the staff. A certified independent observer can be assigned to monitor the hand hygiene practices in the hospital. However, if you want a more indirect method, measuring product use like soap and sanitizer can be done. Compute hand hygiene opportunities against how often the staff engaged in said opportunities. Electronic monitoring, though expensive, is a good option, particularly if you are after real-time feedback on compliance.

5. Make it easy

Place dispensers near the door so caregivers are reminded to wash hands before and after patient interaction. Also, choose hand hygiene products that work well for the staff. Avoid gels that leave the hands dry, chapped, or cracked. Finally, push hand hygiene programs in a positive way. Enforce changes using support, not punishment. Improve the process and the workflow to make it easy for everyone to become active participants and to provide honest feedback.

With the right strategies, the proper behaviors that improve hand hygiene will flourish throughout your hospital. Implement the necessary changes in a supportive, rewarding, and fun way so that all healthcare providers come together to spur positive change.