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Health care associated infections (HAIs) affect up to one in twenty hospitalizations or 1.7 million persons annually in the U.S., exceeding four billion dollars in costs  and resulting in approximately 100,000 deaths. In Europe, there are an estimated five million annual cases of general nosocomial infections, infections acquired in a hospital, with 2.7% of cases (135,000 annually) being a contributor to death . Although many factors contribute to the development of HAIs, hand hygiene is considered the single most important measure for limiting nosocomial transmission of pathogens . Hand hygiene compliance is generally considered to be suboptimal and remains a constant challenge for infection control programs. Health regulatory and advisory agencies, such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and The Joint Commission, all recommend or demand that hospitals monitor hand hygiene compliance.