Why is the commitment of the healthcare workers the real key to improving hand hygiene?

Sani Nudge solution has been designed with a critical goal in mind – to improve hand hygiene. Based on the nudging theory and behavioral science, Sani Nudge offers practical improvement tools that ensure sustained hand hygiene performance and, most importantly, reduce hospital-acquired infections.

How exactly does Sani Nudge improve hand hygiene?

Compared to regular practices such as e-learning, posters, and stickers, the Sani Nudge solution provides one significant advantage – it doesn’t lead to the phenomenon known as poster blindness. Most of the regular practices fail to sustain a behavior change over a long time because of the selective nature of our attention. If we are repeatedly exposed to the same stimuli, we ignore them. Similarly, a concept such as e-learning can positively affect behavior initially. However, these effects do not usually last over extended periods if people are not regularly reminded.

Sani Nudge uses light-guided nudging and data-driven performance feedback to boost hand-hygiene compliance significantly. Light-guided nudging can be adjusted to a particular time and specifically target the departments that need the most help to focus on hand hygiene compliance. Importantly, anonymous and comprehensive data accurately report hand hygiene levels and serve as a way to increase motivation at both the individual and team levels.

Why is the commitment of the healthcare workers the real key to improving hand hygiene?

Although proper hand hygiene is considered the most critical measure to prevent the spread of infections, many hospitals fail to comply with recommended guidelines fully. Without a doubt, healthcare workers care about patient safety and want to provide good care. However, it is also common knowledge that individuals often overestimate their performance, especially hand hygiene.

Many studies have pointed out the importance of continuous monitoring programs that include feedback. Seeing the data firsthand promotes a sense of accountability and reinforces the commitment to better care. However, it is crucial to switch the view of accountability from negative and punitive to positive and rewarding. In other words, it is essential to make the organization’s culture open to improvements by including healthcare workers in the co-creation of a safer environment.

In the recent episode on the Hygiene and infection prevention network, Patricia Stone, infection prevention and control pioneer, summed it up very well:

“Culture, money makes a difference, and we all work for money, but the organizational culture is the most important thing. People go into healthcare for a reason, and that reason is often to provide good care, and if they see improvement areas, they should have a culture where it is okay to bring it up and come with suggestions.”


Sani Nudge’s favorite tips and guidance


1.    Weekly Improvements and WHO’s five moments of Hand Hygiene

The WHO concept “Hand hygiene at the point of care” emphasizes the need to perform hand hygiene exactly where patient care occurs. Weekly improvements allow you to enforce this concept in the patient rooms by showing hand hygiene levels before and after patient contact – or combined.

2.    Setting measurable goals

It’s time to set practical goals. The Weekly Improvements page provides Hygiene mentors with the opportunity to develop a goal for each room type. These goals increase the motivation of healthcare workers to work towards something measurable.

3.    Individual Motivation

This tool enables healthcare workers to see their hand hygiene level in a weekly email. Behavioral science studies have documented how important it is to be specific with data to change habits. This is now possible with Individual Motivation. Everyone is anonymous, and the user is the only one to view their hand hygiene level. 

4.    Celebration of successes

Improving hand hygiene levels should be celebrated! This is important for motivation. It is up to an individual organization to choose the form of celebration, but in any case, small rewards and celebrations should be a part of the working culture.


Over the years, it’s been shown that human beings, compared to machines, have a limited ability to process information. Although we are very creative, self-aware, and imaginative, we are also easily distractable and sometimes prone to what we call “silly mistakes.” The growing field of human factors engineering explores designing an environment that addresses the hidden factors that influence our behavior. Together with other emerging theories and interventions, this field will play a critical role in the future of improved hand hygiene.

As Hugo Sax, a creator of ‘My five moments for hand hygiene, stated:

“It’s all about realizing the strengths and weaknesses of human beings.”


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3 reasons you shouldn’t trust direct observations

Hand hygiene compliance has for a long time been measured via Direct Observations (DO). However, let’s be realistic; if Direct Observation was the answer, the nationwide average wouldn’t still be below 50%.

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