Background: Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact
with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use
a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a
hospital cafeteria.
Methods: Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand
hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline,
intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch.
Results: During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%.
Hygiene attempts occurred more frequently by HCWs than HVs (P 5 .0008) and females than males (P 5 .0281). Hygiene attempts
occurred more frequently after poster introduction than baseline (P 5 .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene.
Conclusion: The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a
US hospital cafeteria.