The challenge is implementing a hand hygiene compliance program that continues to work, every day with every encounter. Hands may become contaminated by simply touching a patient’s skin, an object in the patient’s room or even taking their blood pressure. Patient Safety Advisory Pennsylvania Board’s (2014) article asserts “A robust hand hygiene improvement program begins with an assessment of barriers to optimal practice. A facility-specific assessment targets hand hygiene system problems, workplace reminders, safety climate, training, evaluation, and feedback on resources, knowledge, compliance, and leadership” (p. 163). Implementing policies and procedures to deal with individuals with a low hand hygiene compliance rate could prove