TY - JOUR T1 - One nudge for hand hygiene JF - BMJ Innovations JO - BMJ Innov SP - 249 LP - 252 DO - 10.1136/bmjinnov-2020-000599 VL - 7 IS - 2 AU - Donald A Redelmeier AU - Richard H Thaler Y1 - 2021/04/01 UR - http://innovations.bmj.com/content/7/2/249.abstract N2 - Summary boxWhat are the new findings?A behavioural nudge can be especially effective and durable if based on sludge reduction, defined as lowering a barrier that discourages people from doing the right thing.We introduced a simple label to encourage people to report an empty hand sanitizer dispenser located in public places inside a large acute care hospital.We later checked 100 dispensers inside the hospital and found only 2 empty (notified and refilled promptly).A similar check of 100 dispensers at a nearby hospital found 11 empty (no readily apparent way to notify for refilling).How might it impact on healthcare in the future?Other hospitals could immediately adopt this nudge to strengthen the connection between intentions and actions for hand hygiene.Crowdsourcing provides a practical method to support hand hygiene by allowing outpatients, families, visitors, staff, volunteers and others to notify hospital services about empty hand sanitizer dispensers that requires refilling.The COVID-19 pandemic has caused over a 100 million cases and substantial numbers of admissions to acute care hospitals. Hand hygiene is a practical, affordable, acceptable, safe, reliable and effective strategy to mitigate the risks of nosocomial transmission to other patients in hospital for other reasons. Hand hygiene is also critical for ensuring the safety of healthcare workers and maintaining overall hospital staffing. However, hand hygiene is fallible because of many cognitive biases in everyday care.1 Clinicians, for example, have no easy way to determine if they are contaminated, whether their hand hygiene is sufficient, or if they are recalling correctly a repetitive activity.2–4One strategy for improving hand hygiene is to increase the availability of hand sanitizer dispensers in public places is to structure more convenient opportunities for repeated hand washing. Each dispenser installation requires no electricity, plumbing or batteries and can be retrofitted onto existing infrastructure quickly and cheaply (figure 1). The logistics mostly require finding a wall … ER -