Rodriguez 2015.

Methods	Stepped‐wedge cluster‐randomised trial in 11 ICUs in hospitals Study period: August 1, 2011 ‐May 1, 2012. A new intervention unit was added each month, and a new intervention component was added each month in each intervention unit. Argentina
Participants	All healthcare workers
Interventions	Multimodal intervention with stepped introduction of leadership support, availability of ABHR, reminders, story boards, and unit feedback
Outcomes	Observed hand hygiene compliance
Notes	Funding source: Patient Safety Small Grant Program, WHO, Switzerland Declaration of interest: Not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Concealed table of random numbers
Allocation concealment (selection bias)	Unclear risk	Participants assigned to intervention or control group once a month as next units added to intervention
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not possible to blind
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
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	High risk	Some differences in baseline; authors identified sites as heterogeneous
Baseline characteristics	Unclear risk	Variation reported but impact unclear
Protection from contamination	Unclear risk	Authors identified that contamination could not be ruled out