Derde 2014.

Methods	Design: ITS Study period: May 2008‐April 2011 6 month baseline period, 7 month intervention period, 11 month follow up
Participants	Europe. 13 ICUs
Interventions	Multimodal campaign based on WHO 5 Moments
Outcomes	Direct observation of hand hygiene; not clear for how long or how often
Notes	Inappropriate analysis for ITS (no segmented regression or equivalent) Funding source: European Commission Declaration of interest: None They also conducted a cluster‐randomised trial related to screening and barrier use which did not have hand hygiene as an outcome
Risk of bias
Bias	Authors' judgement	Support for judgement
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not specified
Blinding of outcome assessment (detection bias) All outcomes	High risk	Data collectors were nurses from the study units trained in data collection
Incomplete outcome data (attrition bias) All outcomes	Low risk	Missing data (missed opportunities) unlikely to be very different in the different study periods
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting
Other bias	Low risk	No evidence
Intervention independent	High risk	Other changes occurred in phase 3 of the study re screening for MRSA and other pathogens, plus concurrent use of barrier and contact precautions
Shape of effect pre‐specified	Low risk	Point of analysis is the point intervention
Intervention had no effect on data collection	Low risk	Same data collection method before and after