Lay summary
Healthcare-associated infections represent the leading preventable adverse event in hospitalized patients. Optimal performance of hand hygiene by healthcare workers is considered the single most important measure to prevent these type of infections. However, hand hygiene remains substandard in most healthcare institutions even after over 10 years of promotion.We will study the relative impact of three promotional strategies to improve hand hygiene from a good level to an excellent level: an intervention based on behavior science including the active involvement of opinion leaders and peers, an intervention consisting in permanent feedback of hand hygiene performance to the concerned healthcare-workers, and an intervention engaging patients in hand hygiene promotion as stakeholders with a direct interest in this topic.We will measure the impact of these strategies on hand hygiene performance and on the rates of healthcare-associated infections and the transmission of multi-resistant pathogens within the hospital.Moreover, we will do a cost-analysis to see which strategy brings the most effect for the effort needed. Finally, we will try to understand if a combination of two or all three interventional approaches will have a synergistic effect.The final study results will be available in 2012.