The business case for hand hygiene: What are the real costs?

Even though improving hand hygiene is the most essential and least expensive strategy to prevent healthcare-associated infections (HAIs) and the emergence of antibiotic resistance, the average compliance rate for this effortless activity is less than 50% (1).  But what are the financial actual costs?

Hand hygiene with Sani Nudge is low-cost and easy

Did you know that each sanitization with the Sani Nudge system costs less than 2 cents? 

To get a clear perspective on what this number means, it can be useful to compare the budget for the Sani Nudge system and hand hygiene products to that of excess costs for healthcare-associated infections (HAIs). 

According to a Swedish study, the average additional costs of the four most common types of hospital-acquired infections in medical and surgical wards are approx. 12.000 EUR per patient (2) (with more severe antibiotic-resistant infection costing up to 34 000 EUR per patient (3)). Moreover,  approximately 7 in 100 hospitalized patients will acquire at least one HAI during their stay.  

For each 30-bed hospital ward, just one HAI of high severity can exceed the annual budget for hand hygiene monitoring system and alcohol-based products combined.

What are the costs of hand hygiene non-compliance?

Infections are transmitted to hospital patients mostly through the hands of healthcare personnel. This usually happens when healthcare professionals forget to wash their hands before touching a patient.

A study at the Duke University Medical Center estimated the cost of MRSA infection resulting from hand hygiene non-compliance during patient care. When the researchers conducted a simulation of 1 million non-compliant events, the results showed:

  • Only a 1% improvement in hand hygiene compliance among healthcare workers in a 200-bed hospital would save over $40,000 per year in MRSA prevention-related costs.
  • If the same hospital increased hand hygiene compliance by 5%, the cost savings could climb up to $200,000 (4).


Did you know …

    • HAIs in the EU hospitals have, on average, direct medical costs of €7 billion each year.
    • Central line-associated bloodstream infections are one of the most expensive types of HAIs, costing approximately 18,241 per patient. 
    • Surgical site infections account for around 1/3 of the total annual cost of HAI treatment with a cost anywhere from €306 to €26,815 per patient.
    • In the EU, it is estimated that 3.8 million people acquire a healthcare-associated infection each year, resulting in 37,000 deaths (>100 per day)
    • If you are admitted to a hospital in the EU, you have a 5-10% chance of contracting a HAI. In ICU, the risk is 5–10 times greater than in general surgical or medical wards.


Approximately 70% of HAIs are preventable with good hand hygiene and other cost-effective IPC practices.

A better path to hand hygiene compliance

Healthcare facility executives should keep in mind that improving hand hygiene compliance by acquiring more effective or acceptable hand hygiene products can help prevent HAIs. Even if only a small number of additional HAIs are prevented each year, the benefits will outweigh the increased expenses of better hand hygiene solutions. 

  • Even in case hand hygiene accounts for less than a 1% drop in HAIs at a facility, it is already considered cost-effective (5).
  • According to another study from Taiwan, every euro spent on a hospital’s 4-year hand hygiene program resulted in a  30.59 return on investment (6).

Proper hand hygiene is crucial to preventing the spread of many HAIs and avoiding unnecessary extended hospital stays. Electronic hand hygiene monitoring systems measure hand hygiene levels to eliminate observer bias. Hand hygiene data is measured constantly and autonomously via the system, allowing the healthcare personnel to monitor hand hygiene compliance in real-time and provide relevant feedback.

Digital solutions like Sani Nudge have great potential to build resilient infection prevention programs. 

With Sani Nudge, hospitals can achieve:

To conclude

Hand hygiene compliance is the most straightforward and cost-effective strategy to prevent HAIs. Showing how noncompliance raises excess expenses while compliance reduces excess costs and boosts revenue should illustrate the need for high-quality hand hygiene compliance monitoring devices. Most importantly, it ensures that everyone is safe.

As WHO stated at the end of their global report on infection prevention and control:

WHO is calling on all countries around the globe to increase their investment in IPC programmes to ensure the quality of care and patient and health workers’ safety. This will not only protect their populations, but increased investment in IPC has also demonstrated to improve health outcomes and reduce health-care costs and out-of-pocket expenses.”


  1. CDC. Hand Hygiene in Healthcare Settings. Available at: Accessed June 12, 2022.
  2. Rahmqvist M, Samuelsson A, Bastami S, Rutberg H. Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements. Am J Infect Control. 2016 May 1;44(5):500–6.
  3. OECD. Tackling Wasteful Spending on Health, OECD Publishing, Paris, 2017. Available at: Accessed June 14, 2022.
  4. Cummings, MD, Keith L.; Andersen, MD, Deverick J.; Kaye, MD, Keith S. Hand Hygiene Noncompliance and the Cost of Hospital‐Acquired Methicillin‐Resistant Staphylococcus aureus Infection. Infect Control Hosp Epidemiol 2010; 31:357-364.
  5. Pittet  D, Simon  A, Hugonnet  S, Pessoa-Silva  CL, Sauvan  V, Perneger  TV.  Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med. 2004;141(1):1-8. doi:10.7326/0003-4819-141-1-200407060-00008
  6. Chen  YC, Sheng  WH, Wang  JT,  et al.  Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections.   PLoS One. 2011;6(11):e27163. doi:10.1371/journal.pone.0027163

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