The Power of Nudging: Insights from Behavioral Science for Hand Hygiene Compliance

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Hand hygiene plays a crucial role in preventing hospital-acquired infections and ensuring patient safety. However, human behavior is complex, and we are prone to cognitive and emotional biases that can hinder compliance. In this blog post, we explore the fascinating insights from behavioral science and the importance of nudging techniques in promoting hand hygiene compliance among healthcare professionals.


The Insights from Behavioral Science on Hand Hygiene Compliance 


Did you know that behavioral science has uncovered at least 14 biases that contribute to non-compliance with hand hygiene protocols? (1)

These biases, often subconscious, influence our decisions and actions without us even realizing it. Understanding these biases is key to overcoming them and improving hand hygiene practices in healthcare settings. Behavioral scientists have highlighted the significance of these insights, shedding light on the factors that impact compliance and the need for effective interventions.

Here are a few examples of cognitive biases that can potentially affect hand hygiene compliance: 


What is Nudging?


At the forefront of behavior change strategies lies the concept of nudging. Coined by behavioral scientists Thaler and Sunstein (2), nudging involves making subtle changes in the choice architecture to predictably alter people’s behavior without imposing restrictions or changing economic incentives. 

It’s about creating an environment that encourages and supports the desired behavior without taking away individuals’ freedom of choice. Nudges are practical, scalable, and cost-effective, making them an ideal approach for driving behavior change.


Different Types of Nudges in Hand Hygiene Compliance


Within the context of hand hygiene compliance, various types of nudges can be employed. One effective approach is using cues or triggers that prompt HCWs to sanitize their hands. These cues, strategically placed in the environment, remind individuals to engage in the desired behavior. 

Another crucial aspect is the provision of rewards. Feedback nudges, such as positive animations or acknowledgements, can serve as rewards for hand hygiene compliance. By associating a sense of accomplishment and positivity with the behavior, these rewards reinforce the habit and encourage sustained compliance.


Leveraging Nudging with the Sani Nudge Solutions


The Sani Sensors provide positive feedback when the healthcare workers have performed the desired behaviour. The nudging consists of a green light that appears on the sensor when the user has performed hand hygiene. The green light works as a positive reinforcement, which is called a reward for performing hand hygiene. The purpose of the reward is to activate a pleasant association with performing hand hygiene. Local hygiene mentors can turn the nudging function on and off whenever the hand hygiene compliance needs a boost.  

nudging sani nudge

This reward system is rooted in the principles of behavioral science, creating an environment that supports hand hygiene compliance without compromising choice or imposing constraints. By utilizing nudging techniques, Sani Nudge empowers healthcare facilities to enhance hand hygiene practices and create a safer environment for patients and staff.

Intelligent nudging

In a recent study conducted at a university hospital, researchers investigated the impact of nudging with sensor lights on HCWs’ hand hygiene compliance. 


The researchers enrolled 91 physicians, 135 nurses, and 15 cleaning staff in the 11-month intervention. An automated monitoring system, Sani Nudge, measured HHC, while reminder and feedback nudges with lights were displayed by the Sani Nudge sensors placed on alcohol-based hand rub dispensers.


The results demonstrated a significant and sustained effect of nudging with lights on HCWs’ hand hygiene compliance.


The study also revealed an interesting finding: the group that received feedback nudges had a more significant effect compared to the group that received only reminder nudges. This suggests that the positive nudging approach, which involved providing feedback on behavior, may be more effective than simply reminding individuals of the correct behavior.


Integrating behavioral science insights and nudging techniques has proven instrumental in improving hand hygiene compliance in healthcare settings. Nudging, combined with reliable data and actionable insights, offers a practical, scalable, and cost-effective approach to drive behavior change and create a safer environment for patients and staff. Contact us at if you want to hear more about how Sani Nudge can help your hospital improve patient and staff safety while saving resources along the way.




1.Caris MG, Labuschagne HA, Dekker M, Kramer MHH, van Agtmael MA, Vandenbroucke-Grauls CMJE. Nudging to improve hand hygiene. The Journal of hospital infection.2018;98(4):352-8.

2. Thaler RH, Sunstein CR. Nudge improving decisions about health, wealth, and happiness. New Haven, Conn: Yale Univ. P.; 2008.

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