Hand washing behavior differs depending on whether a person is being watched and this also includes health care workers according to a new study.

Hand hygiene is one of the most essential practices in health care environments lessening the chances of harmful bacteria and toxins from spreading to vulnerable areas and is widely practiced in hospitals across the world. However, according to a recent study carried out at Santa Clara Valley Medical Center (SCVMC) in San Jose, California, health care workers’ behavoir on hand washing changed dramatically depending on whether they were being evaluated or not.

It seems human behavior is hard to change. The research carried out involved observing hospital staff by using a set of Infection Prevention (IP) nurses and young volunteers. Each observed the staff for hand-washing habits and found when being watched by IP nurses, staff washed their hands according to hygiene rules around 57 percent of the time while this dipped to 22 percent when a volunteer was present, as explained in an ABC News report.

“[We noticed] a very consistent trend that our Infection Prevention nurses were seeing something different than what volunteers were seeing,” noted Maricris Niles, an infection prevention analyst at SCVMC.

“When we would come on the floor, I would notice that the nurses or providers were not using the alcohol,” Lisa Hansford, one of the IP nurses explained. “Then they would glance up and see me and bend over backwards to lather up.”

The findings, presented at the Association for Professionals Infection Control and Epidemiology meeting in North Carolina this weekend, highlight the need to carry out stringent interventions to raise the rates of hygiene in hospitals to an acceptable level. One way would be to publish and show publicly all hygiene adherence data to cultivate competition between different hospitals and departments.

The study is not to show up dedicated health care workers who work hard day and night as many need to wash their hands hundreds of times during an eight hour shift. It’s down to the difficulty of changing human behavior and the results hope that strategies can be implemented in a way that will cause people to automatically reach for the alcohol dispensers rather like putting on a seatbelt in a car.