The study evaluated the effectiveness of a hand hygiene monitoring program over a year-long period in two hospital care units. The hand hygiene monitoring program consisted of education, visible monitors, immediate feedback, and real-time data dissemination to leadership. The two intervention wards showed statistically significant increases in compliance from 49% to an average of 90% and from 60% to an average of 96%. Compliance rates were significantly higher in intervention wards compared to control wards. Continuous monitoring and immediate feedback are crucial to the success of hand hygiene programs.