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Wa(tc)sh out! The effects of cues of being watched on implicitactivation of norms and hand disinfection behaviour

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Hospital staff frequently has to cope with complex information, unpredictable circumstances, and prompt decision making. In such an environment, even the “Gods in white” are susceptible to fatigue and error. Noncompliance with hand hygiene guidelines in hospitals is one of these errors and enhances the risk that microorganisms are transmitted between staff and patients. Previous approaches to enhance this compliance aimed at raising awareness on hand hygiene, such as performance feedback or strategic sink placement, and have only appeared to be partially or temporarily successful. Research on human cooperative behaviour has demonstrated that subtle cues of being observed, such as an image of eyes, could enhance compliance with instructions (Bateson et al, 2006). It has been suggested that these cues might activate motivation to follow a local cooperative norm (Ernest-Jones et al, 2010). However, the underlying psychological mechanisms of possible implicit norm activation remain questionable, and it is unclear whether eye-cues could improve hand disinfection behaviour. We conducted two experiments to investigate this


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