Patient Inclusion Criteria:  Patients ≥ 18 years of age having surgery in an adult operating suite at the research center involving the following specialties: orthopedics/spine, orthopedics/total joint, gynecology/oncology, colorectal, open vascular, and open urological, general abdominal, acute care, cardiothoracic, and plastic/breast.  Patient Exclusion Criteria:  Patients with a known infection at the time of surgery. Prisoners Pregnant Women Patients lacking capacity to consent Patients with an allergy to a component of hand hygiene solution, such as ethyl alcohol Refusal of consent  Anesthesia Provider Inclusion Criteria:  • Faculty physicians, resident physicians, or certified registered nurse anesthetists that provide care for adults having surgery at the research center.  Anesthesia Provider Exclusion Criteria:  Refusal of consent Open sores of the hands Known skin infection