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Hand hygiene has become an integral part of our culture. Hand washing has been taught at home, every level of school, advocated in the workplace and stressed during nursing and medical programs (Mortell, 2012, p. 1011). According to the CDC, hand hygiene is a simple, cost effective, important strategy in preventing the spread of infection and is recognized as the most important factor in reducing and preventing healthcare acquired infections-HCAIs (Mortell, 2012, p. 1011). And yet, compliance to hand hygiene guidelines is a problem at most hospital settings. In fact, compliance rates have been measured as low as 26% (Mortell, 2012, p. 1012).

Most research conclusions regarding HCAIs suggest that health care providers cite a lack of education or orientation to workplace hand hygiene practices. In addition, lack of priority, insufficient time, inconvenient facilities for hand washing, allergy to or intolerance of antiseptics and lack of leadership, whether from role models or senior management, are also blamed (Mortell, 2012, p. 1012). With the current evidence base emphasizing the importance of hand hygiene, it is difficult to rationalize why health care providers continue to be resistant to hand hygiene practices. Even the spread of multidrug-resistant pathogens, such as MRSA, has not compelled staff to adopt recommended practices; and even though infection control programs are in place in many health care organizations, failure to comply with them remains high (Mortell, 2012, p. 1012). Therefore, more research is needed to develop strategies that promote hand hygiene compliance and development of hand hygiene surveillance techniques and implementation designs.

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