Effects of light-guided nudges on health care workers' hand hygiene behavior.

Hospital-acquired infections are the most frequent adverse events in health care and can be reduced by improving the hand hygiene compliance (HHC) of health care workers (HCWs). We aimed to investigate the effect of nudging with sensor lights on HCWs' HHC. An 11-month intervention study was conducted in 2 inpatient departments at a university hospital. An automated monitoring system (Sani Nudge^TM) measured the HHC. Reminder and feedback nudges with lights were displayed on alcohol-based hand rub dispensers. We compared the baseline HHC with HHC during periods of nudging and used the follow-up data to establish if a sustained effect had been achieved. A total of 91 physicians, 135 nurses, and 15 cleaning staff were enrolled in the study. The system registered 274,085 hand hygiene opportunities in patient rooms, staff restrooms, clean rooms, and unclean rooms. Overall, a significant, sustained effect was achieved by nudging with lights in relation to contact with patients and patient-near surroundings for both nurses and physicians. Furthermore, a significant effect was observed on nurses' HHC in restrooms and clean rooms. No significant effect was found for the cleaning staff. Reminder or feedback nudges with light improved and sustained physicians' and nurses' HHC, and constitute a new way of changing HCWs' hand hygiene behavior. • Nudges with lights improved hand hygiene (HH) compliance. • We found an effect of light nudges on nurses' and physicians' HH in patient rooms. • We found an effect of light nudges on nurses' HH in restrooms and clean rooms. • Light nudges did not significantly change cleaning staff's behavior. • Single nudges were as effective in changing HH behavior as combined nudges. [ABSTRACT FROM AUTHOR]