-Ensure that alcohol-based hand rubs and soap are available as close to the point of care as is reasonable.
- Establish a hand hygiene team responsible for implementation of the Hand Hygiene Protocol.
    The protocol to include mandatory training for all healthcare workers (HCWs) upon hire and on-going at least once annually. Training to     include:
        ●      Proper technique for hand rubbing and soap and water washing
        ●      Indications for hand rubbing vs soap and water washing (WHO or CDC Guideline)
        ●      How to speak up when fellow HCWs do not comply (psychological safety is a vital condition of an effective safety culture)
        ●      Education for patients, family members and visitors.
- Performance Evaluation and Feedback
    It is essential to measure hand hygiene compliance accurately and reliably using a validated method capable of capturing and reporting on     100% of all hand hygiene events such as an evidence-based electronic hand hygiene compliance system. Such systems have been shown to lead to sustainable improvement, reduced infections & costs and a positive impact on patient safety culture.\cite{Bouk_2016} \cite{Kelly_2016}\cite{Michael_2017}\cite{Son_2011}
            ●      Measure hand hygiene compliance using an evidence-based, validated electronic hand hygiene compliance system. 
            ●      Provide performance feedback to unit leadership and frontline staff on a daily or weekly basis using evidence-based behavior change feedback models. \cite{21775022}
- Reminders in the workplace such as posters, brochures, leaflets, badges, stickers, etc. can be used provided they are consistent with the overall Hand Hygiene Protocol and any organizational wide campaigns to focus attention on the importance of hand hygiene.