“…Despite the fact that these recommendations have been enforced as regulations in the United States as part of the blood-borne pathogens standard, most studies assessing the hand hygiene compliance of HCWs before and after the implementation of these requirements have shown low compliance rates, averaging approximately 40% and ranging as low as 10%. [203][204][205][206][207][208][209][210][211][212][213][214] Compliance rates often have remained relatively low despite considerable efforts to improve them. For instance, one hospital increased its overall compliance rate from 48% to 66% following the implementation of a multi-year hand hygiene campaign involving "talking walls" designed by psychologists, artists, and infection control specialists to motivate increased compliance.…”