Hand hygiene remains a fundamental component of infection prevention, yet ensuring sustained compliance requires more than knowledge of guidelines. This chapter explores the implementation of the WHO multimodal strategy as a behavioural and structural framework aiming to achieve meaningful, lasting improvement in hand hygiene practices. Beginning with structural requirements and foundational concepts, the chapter places hand hygiene within a broader context of system change, feedback culture, education, and safety climate. Nurses and other healthcare professionals are highlighted as key enablers—educators, auditors, campaigners, and culture shapers. The role of auditing is reframed as a source of reflection and shared learning. Digital innovations, including real-time dashboards and wearables, are acknowledged as valuable tools that offer healthcare teams timely, actionable insights while reducing manual monitoring burdens. While not the central focus, their role is explored and embraced as part of a modern, integrated approach to hand hygiene improvement. When supported by leadership, feedback, and patient involvement, hand hygiene is not simply performed—it is understood, valued, and owned. Grounded in a clear understanding of the ‘why’, enabled by a practical ‘how’, and delivered through an empowered ‘what’, hand hygiene can evolve into a resilient standard of safe, professional care.