The Institute for Healthcare Improvement in its How-to Guide: Improving Hand Hygiene recommends a multidimensional approach (i.e., introduction of alcohol-based hand rub, and educational and behavioral initiatives) to improve compliance with hand hygiene guidelines in healthcare settings.40 The science supporting a multidimensional hand hygiene program (glove use is included in this strategy because proper glove use is inextricably linked to effective hand hygiene) is sufficiently established to be considered a standard and consist of four components (Table 4). While these four components of best practices individually improve hand hygiene compliance, when applied together they are substantially more effective.