BACKGROUND: We hypothesized that the addition of a novel verbal electronic audio 
reminder to an educational patient hand hygiene bundle would increase 
performance of self-managed patient hand hygiene.
METHODS: We conducted a 2-group comparative effectiveness study randomly 
assigning participants to patient hand hygiene bundle 1 (n = 41), which included 
a video, a handout, and a personalized verbal electronic audio reminder (EAR) 
that prompted hand cleansing at 3 meal times, or patient hand hygiene bundle 2 
(n = 34), which included the identical video and handout, but not the EAR. The 
primary outcome was alcohol-based hand sanitizer use based on weighing bottles 
of hand sanitizer.
RESULTS: Participants that received the EAR averaged significantly more use of 
hand sanitizer product over the 3 days of the study (mean ± SD, 29.97 ± 17.13 g) 
than participants with no EAR (mean ± SD, 10.88 ± 9.27 g; t73 = 5.822; 
P ≤ .001).
CONCLUSIONS: The addition of a novel verbal EAR to a patient hand hygiene bundle 
resulted in a significant increase in patient hand hygiene performance. Our 
results suggest that simple audio technology can be used to improve patient 
self-management of hand hygiene. Future research is needed to determine if the 
technology can be used to promote other healthy behaviors, reduce infections, 
and improve patient-centered care without increasing the workload of health care 
workers.