Proper hand hygiene plays a critical central role in any infection control program. To be effective, attention must be given to hand hygiene in facilities planning, in training and implementation of improved practices. All healthcare workers (HCWs) and support staff must be active participants. There are three key levels of hand hygiene—routine hand wash, antiseptic hand wash and surgical scrub. Each level of hand hygiene contributes to the overall effectiveness of infection control within healthcare facilities. Monitoring and maintenance of very high levels of HCW compliance are challenging and require specific attention by infection control professionals.