Abstract: A hygiene monitoring system is provided, where the system includes a location sensor that determines the location of a user within a healthcare area, hygiene zone and/or patient zone; customizable, predefined rules that determine when a hand washing event is required based upon to the location of that user or relative location of multiple users; and a hand washing register and a soap level meter in communication to determine whether a hand washing event has occurred. The hand wash register can determine if a user is within proximity of the soap dispenser, can determine whether the user's hands are underneath the soap dispenser, and can receive an indication from the soap level meter to determine whether the soap dispenser has been used and/or if the soap dispenser was used by the user while within proximity of the soap dispenser. The system can collect the corresponding data and provide real-time alerting and reporting.