Hand washing is the single most important function in preventing the spread of infection. However, compliance by healthcare workers still remains under 50%. Intensive observational and interventional programs have been shown to increase compliance, but the increase in compliance is short-term. Therefore, in April 1998, we conducted a random survey of 500 members of the Association for Practitioners in Infection Control and the Society for Healthcare Epidemiology of America to determine the didactic educational practices (in-service lectures) of practitioners with regard to hand washing. Response rate was 18% (n = 90). Eighty-eight percent (73) conducted new employee orientation, 64% (73) conducted yearly in-service, whereas monthly, quarterly, and semiannual in-service were 11% (9), 11% (9), and 14% (12), respectively. Thirty-nine percent (35) of our respondents rated their compliance to hand washing as > 50%; 31% (19), < 50%; and, 39% (33) did not know. Only 5% (4) of our respondents determined the outcome measures and cost-effectiveness of their present handwashing program. Our survey had identified the lack of ongoing education for the healthcare worker about handwashing compliance. Continuous reinforcement through monthly in-service is labor-intensive and costly. An alternative model using the patient as ongoing reinforcement may be a solution for increasing compliance.