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Table 1 Description implementation strategies

From: Helping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses

State-of-the-art strategy Extended strategy
Education All elements of the state-of-the-art strategy
Distribution of educational material/written information (leaflet) about hand hygiene • Education, reminders, feedback, facilities and products
• The importance of hand hygiene Setting norms and targets within the team
• Misconceptions about alcohol-based hand disinfection • Three interactive team sessions that includes goal setting in hand hygiene performance at group level
• Theory and practical indications for the use of hand hygiene • Analysis of barriers and facilitators to determine how they could best adapt their behaviour in order to reach their goal
Website http://www.gewoonhandenschoon.nl • Nurses address each other in case of undesirable hand hygiene behaviour
• Educational material/written information about hand hygiene Gaining active commitment and initiative of ward management
• Knowledge quiz • Ward manager designates hand hygiene as a priority
• Reward for the nursing ward with the most visitors to the website • Ward manager actively supports team members and informal leaders
Educational sessions on prevention of hospital acquired infections • Ward manager discusses hand hygiene compliance rates with team members
• Launching hospital wide campaign with practical demonstrations of hand hygiene Modeling by informal leaders at the ward
Reminders • Informal leaders demonstrate good hand hygiene behaviour
• Distribution of posters that emphasized the importance of hand hygiene, particularly alcohol-based hand disinfection • Informal leaders models social skills in addressing behaviour of colleagues
• Interviews and messages in newsletters or hospital magazines • Informal leaders instruct and stimulate their colleagues in providing good hand hygiene behaviour
• General reminders by opinion leaders/ward management  
Feedback  
• Bar charts of hand hygiene rates of every nursing ward will be sent to the ward manager twice  
• Comparison ward performance and hospital performance  
Facilities and products  
• Screening and if necessary adapt products and appropriate facilities