Figure 1: Increase of compliance rates achieved by leveraging the Sani nudge system
Firmly establishing hand hygiene is key to infection prevention. Unfortunately, successful implementation of hand hygiene programs can be a major challenge for hospitals. Current strategies fail to increase compliance rates and put patient lives at risk.

Hand hygiene has been proven to be the key tool to prevent healthcare-associated infections to protect the health of patients and healthcare workers (HCWs) [1].

Consequently, sanitizing hands before and after patient contact is a simple solution to prevent the spread of bacteria and viruses in hospitals. To guide their healthcare workers, hospitals do typically use hand hygiene policies. Achieving a high level of compliance is, however, not that simple. The implementation of these guidelines is usually poor and various studies do accordingly indicate that compliance with hand hygiene guidelines is at suboptimal levels [2-3]. On average, HCWs clean their hands less than half of the times they should [4]. So why is that?

Reasons for low hand hygiene compliance

The reasons for low compliance rates amongst HCWs are manifold:

  • Pathogens carried on hands are invisible
  • Linking patient contact to an infection is difficult
  • Cost of time for HCWs
  • High workload
  • Understaffing
  • Ignorance of guidelines
  • The benefit accrues to the patient, not the staff [5-6]
  • Direct observations lead to compliance overestimation
How to develop a habit of hand hygiene?

Performing hand hygiene on a regular basis is something that happens on a subconscious level. The challenge is to create this habit without forcing it on to the staff. There is already great awareness for hand hygiene and HCWs do know of its importance. The missing piece is a tool that helps to develop a habit of hand hygiene whilst creating a collaborative safety culture instead of a shaming culture. It is exactly this where Sani nudge can help healthcare institutions. The system makes the invisible tangible by providing reliable data. It discreetly ingrains hand hygiene as an automatic habit and boosts hand hygiene compliance to unprecedented levels.

Figure 1 describes the increase of compliance rates across three departments (Medical department, ­oncology department and orthopedic department). “Baseline” refers to a testing phase of several weeks where the HCWs wore Sani Ids and carried on their job as normal. The head nurse and hygiene nurse received no information from Sani nudge so they would not influence the score. The objective was to measure what their true level of compliance was in their daily routine. “Intervention” describes the period of time in which the staff was allowed to leverage the insights our system provides to increase compliance. Comparing the baseline phase with the intervention phase, the three departments saw an average compliance rate increase of 88.42%. It is therefore not an overstatement to say that the implementation of Sani nudge can make all the difference when fighting spread of infection in healthcare settings.

Contact us to learn more

If you are looking for a solution that increases hand hygiene compliance rates across hospital departments, don’t hesitate to get in touch. We are always happy to discuss your healthcare facility’s specific needs and to help with your infection prevention efforts.


[1] https://www.bode-science-center.com/center/expert-knowledge/hospital-acquired-infections/detail-hospital-acquired-infections/article/abstract-the-relevance-of-hand-hygiene-for-the-prevention-of-nosocomial-infection.html

[2] https://www.news-medical.net/news/20190415/Low-hand-hygiene-compliance-found-among-healthcare-workers-on-ICUs.aspx

[3] Ay, Pinar & Gulsen Teker, Ayse & Hidiroglu, Seyhan & Tepe, Pinar & Surmen, Aysen & Sili, Uluhan & Korten, Volkan & Karavus, Melda. (2019). A qualitative study of hand hygiene compliance among health care workers in intensive care units. The Journal of Infection in Developing Countries. 13. 111-117. 10.3855/jidc.10926. Available from: https://www.researchgate.net/publication/331429920_A_qualitative_study_of_hand_hygiene_compliance_among_health_care_workers_in_intensive_care_units

[4] https://www.cdc.gov/features/handhygiene/index.html

[5] Sharma S. Hand hygiene and hospital-acquired infections. Med J DY Patil Vidyapeeth [serial online] 2018 [cited 2019 Aug 16];11:201-2. Available from: http://www.mjdrdypv.org/text.asp?2018/11/3/201/235563

[6] https://www.healio.com/infectious-disease/nosocomial-infections/news/print/infectious-disease-news/%7Bdd1e115b-8a00-4889-9e85-8566391f2541%7D/infection-prevention-in-hospitals-the-importance-of-hand-hygiene