Background: A large body of literature suggests that hand hygiene (HH) is considered an integral part of infection prevention strategies. While the majority of initiatives focus on health care providers, school HH programs are gaining traction. Translational research suggests incorporating a similar multimodal, bundled approach to the school setting as seen in health care. This approach involves learning from administrators and teachers about perceptions of HH in the school, understanding perceived barriers to HH, implementing an age-appropriate educational plan, and directly observing behaviors to assess for change. The process analysis suggests a framework that includes identifying shortfalls in practice and behavioral adaptations to ensure long-term success. At the designated early childhood education center, hand washing is encouraged; however, no formal policy or program is in place. Evidence-Based Practice Framework: Stevens’ Star Model of Knowledge Transformation and Milio’s Framework for Prevention served as the framework for the quality improvement project. Methods: Based on the determination of best practices in community health and the designated site’s needs, a two-fold data collection method was designed: a formal proces evaluation of the program as a whole and a quasi-experimental pre-test/post-test survey to the teachers and staff. The survey is adapted from the WHO Hand-Hygiene Self-Assessment Framework. Findings/Results: The process evaluation of the bundled hand hygiene revealed two process indicators, or themes, followed throughout the program implementation: HH opportunities and HH reminders. Additionally, this project measured the teachers’ awareness of hand hygiene in the designated school before and after an educational intervention and program implementation. The pre- and post-survey design revealed significance for an increase in non-verbal reminders throughout the environment and significance for an increase in alcohol-based hand cleaners throughout the environment. Conclusions/Recommendations: Implementing a school-based, bundled HH program increased teachers’ awareness of HH practices throughout the school. Awareness and acknowledgement of HH opportunities through the child’s day increased and reminders beyond verbal cues were utilized more frequently. Therefore, it can be concluded that when implementing intentional measures at increasing HH in the school, the school as a whole will encourage a healthy HH environment. It is recommended that the school continue providing HH non-verbal reminders, adult modeling, and leadership support to HH.
