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Relationship between systems-level factors and hand hygiene adherence.
Dunn-Navarra AM, Cohen B, Stone PW, Pogorzelska M, Jordan S, Larson E. J Nurs Care Qual. 2011;26:30-38.   

This study found that organizations that prioritized teamwork—specifically by using morning huddles among nurses—reported higher rates of hand hygiene. Although system factors may play a role in suboptimal hand hygiene, some observers have argued for greater emphasis on individual responsibility in this area.

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