Reduction of hospital-acquired infections using the Sani Nudge system

Sani NudgeTM is a comprehensive system for preventing infectious disease transmission. The system is designed to empower healthcare professionals to reach compliance goals. In this paper, we show how implementation of the Sani NudgeTM and the 4-step improvement tool has improved hand hygiene compliance by 200% and reduced hospital-acquired infections (HAIs) by up to 64%. In addition, we show the cost savings associated with improved hand hygiene and reduction in HAIs.
Lack of proper hand hygiene

Hospital-acquired infections (HAIs), including infections by multidrug-resistant organisms, constitute a global problem that requires immediate action. Hand hygiene performance according to recommendations is the most important method to reduce infections in healthcare settings. However, most hospitals struggle to improve hand hygiene performance.

4-step improvement tool

Sani NudgeTM uses a 4-step improvement tool based on 3-years of tests in hospitals and feedback from healthcare workers. This extensive research has resulted in a multimodal approach using automated hand hygiene monitoring and performance feedback as well as healthcare worker education and reminders.

Using the 4-step improvement tool for one year, hospitals significantly improved hand hygiene performance by up to 200%, which was associated with a 64% reduction in clostridium difficile infections as well as a 29% reduction in urinary tract infections and bacteraemia, respectively (Figure 2).


Figure 2: Reduction of HAIs after implementing the 5-step improvement tool

Saving lives and money

HAIs continue to be one of the most common adverse events in health care delivery, affecting at least 7% of all patients [1-3]. Of these, 10.5% will die due to the acquired infection [4]. There is a difference in the occurrence and treatment costs of the investigated urinary tract infections, clostridium difficile and bacteraemia (Table 1) [5-8].

Overview-of-HAI-Occurance-1024x256Based on the clinical results, installing the Sani Nudge system prevents 1706 infections, saving 179 lives and $4,25 millions annually when installing on an average-sized hospital (Table 2).


*200,000 admissions per year (600 bed hospital) **Total of urinary tract infections, clostridium difficile and bacteraemia. Based on a 64% reduction in clostridium difficile infections and a 29% reduction in urinary tract infections and bacteraemia, respectively.


Implementation of Sani NudgeTM and the 5-step improvement tool results in significant improvements in hand hygiene performance, clinically relevant reductions in HAIs and lives saved as well as significant cost reductions for hospitals.

Are you interested in learning more? Contact us so we can discuss your hospital’s specific needs.

[1] Burke JP. Infection control – a problem for patient safety. N Engl J Med. 2003 Feb 13;348(7):651–6.

[2] Bates DW, Larizgoitia I, Prasopa-Plaizier N, Jha AK, Research Priority Setting Working Group of the WHO World Alliance for Patient Safety. Global priorities for patient safety research. BMJ. 2009 May 14;338:b1775.

[3] Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet Lond Engl. 2011 Jan 15;377(9761):228–41.

[4] Data Portal | HAI | CDC [Internet]. 2019 [cited 2019 Jul 10]. Available from:

[5] Estimating the Additional Hospital Inpatient Cost and Mortality Associated With Selected Hospital-Acquired Conditions | Agency for Healthcare Research & Quality [Internet]. 2017 [cited 2019 Jul 10]. Available from:

[6] Healthcare-associated-infections-antimicrobial-use-PPS.pdf [Internet]. [cited 2019 Jul 10]. Available from:

[7] Reigadas Ramírez E, Bouza ES. Economic Burden of Clostridium difficile Infection in European Countries. Adv Exp Med Biol. 2018;1050:1–12.

[8] Vallejo-Torres L, Pujol M, Shaw E, Wiegand I, Vigo JM, Stoddart M, et al. Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study. BMJ Open. 2018 12;8(4):e020251.

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