Munoz‐Price 2014.
| Methods | Design: RCT with cross‐over Study period: Dates not stated. Each participant was randomised to receive either the intervention or control first, was monitored for all activities with 1 patient (up to 120 minutes), then within a month was re‐monitored in the opposite arm USA |
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| Participants | Anaesthesiologists and CRNAs | |
| Interventions | Placement of ABHR dispenser on cart + wall vs wall only | |
| Outcomes | Observation of hand hygiene compliance | |
| Notes | Appropriate analysis Observer effect not a concern since participants did not know what outcome was being measured Funding source: GoJo provided the alcohol product and dispensers Declaration of interest: None |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Random‐number generator used to select OR, then group allocation determined by electronic files based on previous block randomisation |
| Allocation concealment (selection bias) | Low risk | Participants assigned to start as intervention or control prior to start of study, then evaluated within 30 days in opposite allocation; did not know what outcome was being assessed |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | ABHR dispenser was visible on cart but researchers said that participants were not aware of what was being assessed |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Outcomes were not assessed blindly |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Missing data (missed opportunities) unlikely to be very different in different arms Similar loss to follow‐up in both groups |
| Selective reporting (reporting bias) | Low risk | No evidence of selective reporting |
| Other bias | Low risk | No evidence |
| Baseline outcomes | Unclear risk | Baseline hand hygiene not reported |
| Baseline characteristics | Low risk | Similar baseline characteristics |
| Protection from contamination | High risk | Participants were assessed once with intervention and once with control conditions but were blinded to outcome being assessed. They may have learned to look for ABHR on the cart when in the intervention arm first, affecting behaviour when they crossed over to the control arm |