| Methods |
Prospective cohort study carried out in 8 private, freestanding long‐term care facilities located in New Jersey and Delaware, to determine the impact of an ongoing infection control intervention programme in reducing the incidence of nosocomial infections. The 8 facilities were selected on the basis of similarity with respect to admission rate, size, acuity levels, availability of services, overall infection rates, in‐house environmental service departments. Resident populations were comparable in terms of age, sex and underlying disease. The 8 facilities were grouped into 4 sets of matched pairs. Within each pair, each home was designated at random as either a test site or a control site. The results was that 4 facilities (2 urban and 2 suburban, with a total of 443 beds), were selected as test sites and another 4 facilities, 2 urban and 2 suburban, with a total of 447 beds, were selected as control sites |
| Participants |
443 beds (patients) in the test group, 447 beds (patients) in the control group. We assumed number of beds as number of participants. |
| Interventions |
Infection‐control education programme reinforcing handwashing and other hygienic measures versus normal care |
| Outcomes |
Laboratory: no
Effectiveness: upper respiratory infections
Safety: N/A |
| Notes |
Risk of bias: high (internal inconsistencies)
Notes: the authors conclude that infection control education measures that reinforce handwashing and other hygienic measures helps reduce the number of organisms present on hands and surfaces and may have contributed to the non‐significant reduction of URTIs (the opposite is reported in the paper: incidence density rate of 4.15/1000 patient days in the test homes versus 3.15/1000 patient days in the control homes) showed in this study. We assumed number of beds as number of participants to the study, but we do not know the characteristics of the patients (age, sex, underlying conditions, etc.). The authors confuse a cohort design with a before and after design and in the report they confusingly use both terms and reach conclusions not supported by the evidence presented |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
N/A |
| Allocation concealment (selection bias) |
Unclear risk |
N/A |
| Blinding (performance bias and detection bias)
All outcomes |
Unclear risk |
N/A |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
N/A |
| Selective reporting (reporting bias) |
Unclear risk |
N/A |
