Improving hand hygiene: thinking outside the bottle

Hand hygiene is an integral aspect of infection control. The provision of Alcohol Based Hand Rub (ABHR) gel at patient bedsides has made effective hand hygiene (HH) more convenient for Health Care Workers (HCWs) by overcoming two of the main ‘barriers’ to HH- time and distance to sinks, by placing the bottles at the point of patient care. The ABHR bottles, being novel, ubiquitous and usually brightly coloured, were originally very effective in cuing HCWs to observe HH. In the years since their introduction, these attributes have not translated into HH rates much above 60%. This suggests that AHR bottles may not have retained the cue to memory they originally held.