Electronic Monitoring Systems

Hand Hygiene Is the Best Way to Prevent the Spread of HAIs

Pamela Wagner


By Pamela T. Wagner, MSN, RN

Clinical Application Specialist, GOJO

Healthcare-associated infections (HAIs) have many negative effects on hospitals and patients – causing thousands of preventable deaths every year and draining valuable resources from the nation’s healthcare system. HAI prevention is typically approached with a bundle of solutions – and hand hygiene is one of the critical components.

Six Studies Confirming the Effectiveness of Hand Hygiene

According to the Centers for Disease Control and Prevention (CDC), practicing regular hand hygiene is the best way to prevent the spread of HAIs. Scientific research dating back to the mid-1800s has established the effectiveness of hand hygiene in preventing the transmission of illness - but modern researchers are able to deploy far more sophisticated methods and technology. These 21st-century studies examine the impact of various clinical interventions on hand hygiene compliance and HAI rates in hospitals.

  • A study published in Behavioral Medicine found that an organizational climate intervention resulted in sustained improvement in hand hygiene performance and an 85% reduction in the hospital’s VRE rate.1
  • Lancet examined a multi-modal intervention including increased access to alcohol-based hand sanitizer and regular performance feedback. Results included an 87% reduction in MRSA cross-transmission rates and a 42% reduction in the overall prevalence of health care-associated infections.
  • A study in Infection Control and Hospital Epidemiology found that a hand hygiene program in a hospital’s neonatal intensive care unit reduced overall HAI rates by nearly 30%.3 
  • A study in the American Journal of Infection Control found that HAI rates fell by more than 40% after an intervention to improve hand hygiene in a tertiary care hospital’s intensive care units.
  • A hospital-wide hand hygiene promotion strategy improved hand hygiene compliance from 20% to 61% and reduced the frequency of healthcare-associated MRSA infections by 50% over a three-year period, according to a study in Antimicrobial Resistance and Infection Control.5
  • According to the American Journal of Infection Control, a multifaceted program increased hand hygiene compliance from 38% to 65% over four years, resulting in decreased rates of MRSA, VAP, CLABSI, and CAUTI.6

The Need for Performance Improvement Is Real

In spite of increased awareness and a growing body of scientific literature demonstrating the efficacy of hand hygiene, it remains a challenge for healthcare workers to comply fully with recommended practices. Hand hygiene rates are frequently overstated in official figures due to the shortcomings of direct observation, particularly the Hawthorne Effect. A recent study using the GOJO SMARTLINK™ electronic monitoring system showed that hand hygiene rates are inflated up to 300% in the presence of an observer—and quickly return to normal when the observation ends. This problem calls for a more sustained effort.

It is critical for hospitals to implement structured programs to monitor and improve hand hygiene practices over the long term. As the Joint Commission has noted, one-time performance improvement goals aren’t likely to drive sustained changes in behavior.

The World Health Organization has recommended that hospitals plan for hand hygiene initiatives to last at least five years to make new behaviors part of the routine for healthcare workers. However, it can be helpful to break the big-picture plan into shorter phases with modest, realistic goals to serve as stepping stones to long-term performance improvement.

Increase Hand Hygiene Compliance With SMARTLINK

Infection preventionists face substantial challenges in their efforts to monitor and improve hand hygiene performance. With limited resources and competing priorities, hospitals are turning to technology to make their hand hygiene initiatives more efficient, reliable

The GOJO SMARTLINK™ electronic hand hygiene monitoring system from GOJO enables hospitals to measure actual opportunities and events at a large scale with 98% accuracy.7  Sensors embedded in soap and sanitizer dispensers wirelessly transmit this raw observation data to back-end software with customizable reporting capabilities.

Infection preventionists can use integrated dashboards and other tools to develop and test hypotheses in real time, and identify target areas where clinical intervention can make a substantial impact on hand hygiene performance. Throughout the process, clinical specialists at GOJO provide peer-level support to help hospitals establish baseline hand hygiene rates, set goals, and monitor their progress.

This integrated system of hand hygiene products, electronic monitoring technology, and clinical expertise enables hospitals to drive long-term behavioral change through recurrent cycles of improvement.

The GOJO SMARTLINK™ system’s modular design provides flexibility – allowing different hospitals to utilize its components in the most effective and appropriate way.


1. Larson et al. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behavioral Medicine, 2000, 26:14-22
2. Pittet et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet, 2000, 356:1307-1312
3. Won et al. Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit. Infection Control and Hospital Epidemiology, 2004, 25:724-746
4. Rosenthal et al. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. American Journal of Infection Control, 2005, 33:392-397
5. Ling et al. Impact of a hospital-wide hand hygiene promotion strategy on health-care associated infections. Antimicrobial Resistance and Infection Control, 2012, 1:13.
6. Jaffar et al. Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. American Journal of Infection Control, 2013, 41(6):482-486.
7. SMARTLINK System Accuracy Lab Testing. 98% room entry and exit accuracy and 100% dispense event accuracy. Conducted in GOJO laboratory. Data on file.

Add your comment

Name Email Comment

View Blog By Author +


Contact Information

Contact: Kelly Ward-Smith, Public Relations Senior Manager

Phone Number: 330-255-6293
Mobile Phone: 330-819-8638

Email: SmithKe@GOJO.com

This contact information is for news media only. For other inquiries, please contact GOJO customer service at 1-800-321-9647 or use the GOJO Contact Us form.