PURELL Hand Sanitizer Doctor using Dispenser

How to Build Accountability Around Hand Hygiene

Lori Moore


By Lori Moore, RN

Clinical Application Specialist, GOJO Industries

It’s essential for healthcare workers to be accountable for their hand hygiene performance because they deal with a large number of people and pathogens every day, and it's well established that hands transmit germs that cause healthcare-associated infections (HAIs). In fact, it is estimated that more than 80% of illnesses are spread by touch.1,2

The CDC identifies hand hygiene as one the most important ways to avoid spreading germs3, and multiple studies have shown that increasing hand hygiene compliance in hospitals helps to reduce HAI rates.

Accurate, reliable measurement is a cornerstone of accountability in hand hygiene.

Hand Hygiene Expectations and Behavior Change Start at the Top

We all know that improving hand hygiene can help save lives. However, sustained performance improvement requires the ongoing support and engagement of hospital leadership, and it’s often difficult to put hand hygiene accountability on the C-suite’s agenda.

Hospital leaders expect hand hygiene to be performed by healthcare workers as an instinctive behavior—like breathing or walking. One of the issues with this is that the penalties associated with inadequate hand hygiene affect the organization as a whole, but not individual workers. Leadership must find ways to create accountability for hand hygiene at the unit or individual level—so staff members are aware when their performance needs improvement.

Accurate Measurement Is Critical to Building Accountability

One of the first things a hospital needs to do to establish accountability around hand hygiene is to develop an accurate and reliable measurement system. You need to examine your current system and make sure the numbers you're getting are accurate, free of bias, and the sample size is large enough.

Relying on direct observation alone is inefficient and labor-intensive, and it often leaves a hospital with too little data to perform any meaningful analysis. That’s why leading hospitals are deploying electronic monitoring systems to capture hand hygiene data. Integrated dispensers, activity sensors and back-end software provide the tools you need to accurately and reliably measure hand hygiene compliance.

SMARTLINK™ Technology Enables Individual or Unit-Level Accountability for Hand Hygiene Compliance

The SMARTLINK™ Technology electronic monitoring system from GOJO enables hospitals to establish unprecedented accountability for hand hygiene. Armed with a larger and more reliable data set, infection preventionists can use integrated dashboards and reporting tools to identify areas for improvement, test hypotheses and track the impact of interventions.

The system is designed with a modular structure that makes integration easy in any hospital environment. Organizations can use SMARTLINK™ Technology in the way that works best for them, whether that means using a real-time location system for individual-level monitoring, tracking performance at the unit level, or supplementing existing measurement with a mobile app for direct observation.

By combining trusted hand hygiene products and clinical expertise with cutting-edge electronic monitoring technology, SMARTLINK™ Technology provides hospitals with everything they need to build accountability and improve hand hygiene performance.



1. Centers for Disease Control and Prevention. CDC Quick Reference Guide for Public Information on Infection Control.
2. 2013 Meta-analysis of germ transmission data by Dr. Gerba, University of Arizona.
3. Centers for Disease Control and Prevention (CDC). Handwashing: Clean Hands Save Lives. http://www.cdc.gov/handwashing/when-how-handwashing.html December 11, 2013. 

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