be placed at critical touchpoints within the workflow. Hand sanitizers should be available in places where healthcare workers need to sanitize their hands most— near the patient, at workstations, and by medical equipment. This strategic placement will ensure that infection control is integrated seamlessly into the daily care process.
Also remember: Vendors need to evolve their technology to capture all hand hygiene opportunities particularly inside the patient room.
What does measuring hand hygiene compliance at the doorway tell you? Really nothing with respect to patient and high touch interaction? Patient and patient environment touches are not a single event. So, you sanitized your hands at the door but touched so many contaminated surfaces while you are inside the patient room.
Don’ t be fooled by slick marketing, pretty dashboards and more data than you are used to. Understand the data as it relates to a safe workflow. Understand your patient and high-touch workflow environment, as it is different for different units.
The Role of Visitors: A Key Element in Infection Control
One often overlooked aspect of infection control is the role of hospital visitors. While healthcare workers are educated and trained in proper hand hygiene, visitors are less likely to be aware of the critical role they play in preventing infection.
Visitors who enter the hospital can unknowingly introduce pathogens to the patient environment by touching common surfaces like door handles, chairs, and the patient’ s bed. Their actions, while well-intentioned, can expose patients to additional infection risks.
Hospitals must implement visitor safety protocols to limit the spread of infection. These protocols should include:
• Require hand sanitization upon entering your facility
• Require mandatory hand hygiene training and education for visitors at time of entry
• Encourage visitors to wash or sanitize their hands before and after interacting with the patient or touching surfaces.
• Post clear signage to remind visitors of the importance of hand hygiene.
• Provide hand sanitizers at the entrances to patient rooms, so visitors have easy access before entering.
Moreover, allowing patients to perform hand hygiene— with dispensers at the bedside— would enable healthcare workers to guide patients in maintaining hygiene, especially when they are most vulnerable. Teaching patients to clean their hands before meals, after using the restroom, or before interacting with medical devices can significantly reduce the transmission of pathogens.
High-Touch Surface Disinfection and the Role of EVS
So, the question is, if hand hygiene compliance is 90-plus percent based on an entry / exit metric, then why are we still seeing infections on the rise and antibiotic resistance increasing unchecked and predicted to be a major health issue in the near future? Could it mean that hand hygiene is not the No. 1 preventive behavior that we thought it was? Or are there other factors that must be synchronized with hand hygiene to make it move the needle on infection?
The Society for Healthcare Epidemiology of America( SHEA) promotes a“ horizontal” versus“ vertical” approach, which suggests multiple simultaneous interventions. The World Health Organization( WHO) promotes patients and high-touch surfaces( Moment 5). What we have learned from the OR is that both work together.
Unfortunately, the further away you get from the OR the less focus and resources are dedicated to hand hygiene compliance and high-touch disinfection. In fact, in many observed cases, EVS personnel don’ t even show up( we call this“ proof of presence”).
How do we know this? Sensor technology allows us to track, map and document human asset activity. Many hand hygiene technologies can provide this data when deployed on EVS personnel. Advanced technology can provide in-room activity data, such as cleaning of workstations, IV poles, bed rails, patient bathroom, etc.
So, do you know what your EVS team is doing, how they are spending their time?
Finally, to support EVS, some thought ought to be given for nursing to do a quick high-touch clean for each patient during turnover. This would ensure that a minimal level of disinfection was performed. If I was a nurse, I would want to ensure
that the hand off of patient and patient environment was safe, both clinically and physically.
Moving Forward: Integrating Infection Control into the Healthcare Workflow
To truly minimize the risk of infection and improve patient safety, healthcare organizations must move beyond static infection control measures.
The key to a more effective approach lies in integrating hand hygiene seamlessly into the healthcare workflow. This means deploying more hand hygiene stations at the point of care, ensuring that they are within arm’ s reach whenever a healthcare worker needs to sanitize their hands.
By working closely with vendors, hospitals can ensure that dispensers are strategically placed at critical points and that the system aligns with the WHO 5 Moments of Hand Hygiene.
In addition to healthcare workers, visitors and patients must be part of the infection control process, and their participation in hand hygiene should be actively encouraged.
Together, we can create an environment where infection prevention becomes an inherent part of every interaction, ensuring that patients are protected and that healthcare workers can perform their tasks without unnecessary barriers.
By addressing these key areas— workflow optimization, strategic dispenser placement, glove use, patient hand hygiene, and visitor safety protocols— we can transform infection control from a task to a natural part of the patient care experience, ultimately reducing the burden of hospital-acquired infections and improving patient outcomes.
Robert Lee, BA, the CEO and founder of MD-Medical Data Quality & Safety Advisors, LLC, is the senior biologist and performance improvement consultant. MD-MDQSA is the home of The IPEX- The Infection Prevention Exchange, a digital collaboration between selected evidence-based solutions that use big data, technology, and AI to reduce risk of HAIs.
26 • www. healthcarehygienemagazine. com • jan-feb 2026