Hand hygiene is easier said than done. Sentara Healthcare, a nonprofit health system that includes 10 acute care hospitals and covers 2 million residents in Virginia and North Carolina, knew that all too well before it launched a system-wide testing and implementation project that increased hand hygiene compliance from about 77 percent to 95 percent. How did it do it? By changing the culture of the system, the hospitals and the staff, including the worst offenders--physicians.

Bloodstream infections, urinary catheter-associated infections and ventilator-associated pneumonia all used to be conditions that were simply considered the cost of doing business at a hospital. Today, those types of healthcare-acquired conditions are avoidable with patient safety advocates making a consorted push for health workers to wash their hands.

The impact of hand hygiene on infections
What worked and didn't work
Changing the organizational culture