Higgins 2013.

Methods	Design: ITS Study period: Baseline for 2 months in November ‐ December 2009 and multimodal campaign to end of 2010. Then in autumn 2011 an e‐learning hand hygiene game was added; it was moved from ward to ward on a mobile station. Data collected until end of first quarter of 2012 Ireland
Participants	Healthcare workers in 1 hospital
Interventions	An e‐learning hand hygiene game: 1 week per unit, twice in1 year. Staff members had multiple opportunities to use it during that time on unit
Outcomes	Hand hygiene compliance
Notes	Inappropriate analysis for ITS (no segmented regression or equivalent) Funding source: None Declaration of interest: None
Risk of bias
Bias	Authors' judgement	Support for judgement
Blinding of participants and personnel (performance bias) All outcomes	High risk	E‐learning hand hygiene game stations used so participants aware of intervention
Blinding of outcome assessment (detection bias) All outcomes	High risk	E‐learning hand hygiene game stations used and visible so observers aware of intervention
Incomplete outcome data (attrition bias) All outcomes	Low risk	Missing data (missed opportunities) unlikely to be very different in various study periods
Selective reporting (reporting bias)	Low risk	All relevant outcomes were reported
Other bias	Low risk	None noted
Intervention independent	High risk	Extra ABHR stations added during the study period and there were 2 interventions occurring at the same time: 1) multimodal and 2) e‐learning hand hygiene game
Shape of effect pre‐specified	Low risk	Point of analysis is point of intervention
Intervention had no effect on data collection	Low risk	Same data collection method before and after