Nudges emphasizing social norms increased hospital visitors’ hand sanitizer use

Abstract

Hand hygiene has taken on new importance as a key behavior for limiting the spread of COVID-19. In the study reported here, we tested ways to increase hand sanitizer use by hospital visitors. We placed dispensers at entrances to hospital units and compared the effect of simply having the dispenser readily accessible (the control condition) with the effects of two nudges: combining the dispenser with an eye-catching sign emphasizing that hand sanitizer use is the norm (“Here we use HAND DISINFECTANT”) or with the same sign except for the addition of an altruistic motive for the norm-emphasizing message (“Here we use HAND DISINFECTANT … to protect your relatives”). Both signs greatly improved compliance, although including the altruistic element did not significantly add to the impact of stating the norm. The results indicate that to improve hand hygiene, hospitals should go beyond locating hand sanitizer dispensers conveniently: they should make the dispensers more visible and stress that using hand sanitizer is the norm.