Lee 2013.

Methods	Design: ITS Study period: March 2008‐July 2010 Baseline: 6 ‐ 7 months, Intervention 12 months, washout 6 months 9 countries in Europe, and Israel
Participants	33 wards, 10 hospitals, all healthcare workers
Interventions	WHO multimodal
Outcomes	Hand hygiene compliance, no feedback Also studied MRSA screening and decolonisation, with MRSA rates as outcome of primary interest
Notes	Appropriate analysis for ITS ( segmented multilevel logistic regression) Funding source: European Commission 6th framework programme Declaration of interest: Harbarth is a member of the speakers' bureau for bioMerieux and Pfizer
Risk of bias
Bias	Authors' judgement	Support for judgement
Blinding of participants and personnel (performance bias) All outcomes	High risk	Included posters and managerial support so participants aware of intervention
Blinding of outcome assessment (detection bias) All outcomes	High risk	Observers were not blinded
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	No evidence of selective reporting
Other bias	Low risk	No evidence
Intervention independent	High risk	Introduction of MRSA screening programme; 10 hospitals over 25 months with no report of whether there were other campaigns, outbreaks etc
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 before and after