Table 2 Parameters and instruments

Hand hygiene compliance

Other parameters

The percentage of opportunities at which hand hygiene was performed according to the National Guideline 'Handhygiene' of the Working group Infection Prevention (WIP) and the WHO Guidelines on Hand Hygiene in Healthcare

The percentage of presence of jewelry and long-sleeved clothes

Hand hygiene monitoring tool

Team Climate

Dimensions 'participation safety,' 'task orientation,' support for innovation,' and 'interaction.'

Team Climate Inventory

Costs and health effects

Comparing resource consumption and HAIs rate between the two implementation strategies

Activity-based costing;

Decision analysis

Process parameter

Description

Instruments

Performance of the strategies

State-of-the-art strategy - Knowledge - number of nurses that completed the knowledge quiz, presence of instruction leaflets. - Reminders - check of presence of posters. - Performance feedback - actual delivery of performance feedback to team members.

Survey, direct observations; systematic registration of time and meeting minutes

Extended strategy - Coaching of ward management- number of coaching sessions, total time spent on coaching, topics dealt with, managers evaluations of coaching. - Coaching of informal leaders - number of coaching sessions, total time spent on coaching, topics dealt with, informal leaders evaluations of coaching. - Team discussions for norm- and target setting - number of nurses attending per ward, time investment per ward, actual norms and targets decided on, nurses' evaluations of team discussions

Barriers to change

Including determinants like awareness, knowledge, reinforcement, control, social norms, leadership, and facilities

Barrier questionnaire

Ward structure

Information about existing structures and resources like actual presence of facilities, workload, nurse-bed ratio -under-staffing and support from the management

Ward structure questionnaire