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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