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Table 2 GRADE evidence profile for vaccination uptake, hand hygiene compliance and knowledge

From: Dissemination interventions to improve healthcare workers’ adherence with infection prevention and control guidelines: a systematic review and meta-analysis

Certainty assessment

No. of patients

Effect

Certainty

No. of studies

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Combined strategies

Comparison

Relative (95% CI)

Absolute (95% CI)

Vaccination uptake (combined strategies vs usual activities)

 4

RCT

Serious a

Not serious

Not serious

Not serious

None

9697/29,506 (32.9%)

5078/24,407 (20.8%)

RR 1.59 (1.54 to 1.64)

123 more per 1000 (from 112 more to 133 more)

Moderate

Vaccination uptake (combined strategies vs single strategies)

 2

RCT

Serious a

Not serious

Not serious

Serious b

None

2695/6255 (43.1%)

888/2085 (42.6%)

RR 1.01 (0.95 to 1.07)

4 more per 1000 (from 21 fewer to 30 more)

Low

Hand hygiene compliance (combined strategies vs usual activities) (assessed with: opportunities for hand hygiene)

 4

RCT

Serious a

Not serious

Not serious

Not serious

None

529/1137 (46.5%)

310/997 (31.1%)

RR 1.70 (1.03 to 2.83)

218 more per 1000 (from 9 more to 569 more)

Moderate

Hand hygiene compliance (combined strategies vs single strategies) (assessed with: opportunities for hand hygiene)

 2

RCT

Serious a

Not serious

Not serious

Serious b

None

1350/1992 (67.8%)

726/1366 (53.1%)

RR 1.16 (0.99 to 1.36)

85 more per 1000 (from 5 fewer to 191 more)

Low

Knowledge (combined strategies vs usual activities)

 1

RCT

Very serious a,c

Not serious

Serious d

Not serious

None

60

60

-

MD 4.1 higher (3.39 higher to 4.81 higher)

Low

Knowledge (combined strategies vs single strategies)

 1

RCT

Serious e

Not serious

Serious d

Serious b

None

Score improvement 17% (IQR 8 to 33%) versus 8% (IQR 8 to 33%); p = 0.27

Very low

  1. Note: CI confidence interval, RCT randomized controlled trial, RR risk ratio, MD mean difference
  2. aProblems in blinding and allocation unconcealed
  3. bNon-significant confidence interval
  4. cSequence generation not adequate
  5. dIndirect outcome for adherence to infection, prevention, and control measures
  6. eIncomplete outcome data