Table 1.
First author and year | Trial design | Setting | Hand hygiene enhancement strategy | Other interventions to reduce MRSA |
---|---|---|---|---|
Pittet et al. [3] | Quasi-experimental | Hospital-wide | ABHR, staff education, reminders, performance feedback and administrative involvement | On-site surveillance, implementation of prevention guidelines, outbreak investigations, and environmental sanitization |
Johnson et al. [5] | Quasi-experimental | Hospital-wide | ABHR, staff education, reminders, performance and feedback and culture change program | Enhanced cleaning of healthcare equipment, and decolonization of MRSA patients |
Grayson et al. [7] | Quasi-experimental | Multiple hospitals | ABHR, education, performance feedback and recommendations for culture change | Individual hospitals observed various MRSA control measures |
Stone et al. [10] | Prospective ecological | Acute NHS hospital trusts, United Kingdom | ABHR, reminders, audit and performance feedback and patient empowerment | Saving lives campaign, Health Act 2006, and visit to trusts by Department of Health improvement team |
Kirkland et al. [11] | Before and after study | Hospital-wide | Leadership accountability, measurement/performance feedback, ABHR, education/training and marketing/communication | None reported |
Lee et al. [15] | Prospective interventional cohort study | Surgical wards | Hand hygiene improvement program as per WHO guideline | Screening and contact isolation and targeted decolonization |
Derde et al. [17] | Hybrid prospective interventional cohort study and RCT | Intensive care units | Hand hygiene improvement program as per WHO guideline | Universal decolonization in phase 2 and screening and isolation in phase 3 |
Abbreviations: MRSA methicillin-resistant Staphylococcus aureus, ABHR alcohol-based handrubs, NHS National Health Service, RCT randomized controlled trial.