Table 1.

Selected studies that specifically assessed the role of hand hygiene enhancement on methicillin-resistant Staphylococcus aureus rates

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.