Environmental engineering to increase hand hygiene compliance Warwick Business School

More than 300,000 patients in England develop a hospital acquired infection (HAI) each year. These infections cost the NHS more than £1 billion annually, as a result of longer stays in hospital and additional treatment costs. A substantial proportion of HAIs could be avoided through simple measures such as better hand hygiene, but studies suggest that recommended hand washing practice is followed less than half of the time.

This project will use a psychological technique known as ‘priming’ to explore how smells and images can subconsciously influence people to follow good hand hygiene practice. In earlier trials on an intensive care unit in the USA, the research team found that introducing a citrus aroma and a picture of someone’s eyes into the hand washing environment triggered significant improvements in hand hygiene.

The new research project will test these interventions on a larger scale, across four wards at Heartlands Hospital in Birmingham. The entry area for each ward will be fitted with an aroma dispenser, with the scent selected following tests to find the one that staff, patients and visitors most strongly associate with cleanliness. An image of eyes will be inserted into a display case above each alcohol hand rub dispenser.

The interventions will be trialled alone for six weeks and then together for another six weeks. Data on the number of people entering the wards and using the alcohol hand rub dispenser will be recorded during observation sessions, and compared with data for control periods when no interventions are live.

Contact details

For more information, contact Darshan Patel, Research Manager at the Health Foundation, or Ivo Vlaev, Professor of Behavioural Science at Warwick Business School.