Simon 2006.

Methods	Prospective cohort surveillance study conducted in the University Children’s Hospital in Bonn, Germany, to assess the global efficacy of a complex intervention programme to contain nosocomial transmission of RSV infections. This is a before‐after design, with a multifactorial intervention carried out in one hospital
Participants	6548 paediatric patients admitted at the University Children’s Hospital in the period of study (2200 in 1999 to 2000; 2298 in 2000 to 2001; 1959 in 2001 to 2002). 283 RSV infections were documented in 278 hospitalised paediatric patients: 138 in 1999 to 2000, 89 in 2000 to 2001, 56 in 2001 to 2002. Of the general population 244 events were ambulatory RSV infections and 39 nosocomial RSV infections
Interventions	Intervention strategy aimed at increasing vigilance to identify and isolate RSV‐infected patients together with enforced contact precautions versus standard procedures. Interventions are not described very well: vigilance + cohorting versus vigilance versus standard practice
Outcomes	Laboratory: All RSV infections were confirmed by antigen detection or cell culture using MS cells Effectiveness: RSV infections no better defined clinically Safety: N/A
Notes	Risk of bias: low The authors conclude that the multi‐factorial prevention strategy (early diagnosis, a strict cohorting and contact isolation policy, and prospective surveillance) probably contributed significantly to the reduced risk of nosocomial RSV infections in the hospital. In the pre‐intervention period there were 39 cases (13.8%) nosocomial infections with an incidence density of 0.99/1000 patient‐days; following the introduction of the surveillance and prevention policy there was a 9‐fold decrease of the incidence (1.67 versus 0.18/1000 patient‐days)
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