Table 2.
GRADE evidence profile for vaccination uptake, hand hygiene compliance and knowledge
| Certainty assessment | No. of patients | Effect | Certainty | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Combined strategies | Comparison | Relative (95% CI) | Absolute (95% CI) | |
| Vaccination uptake (combined strategies vs usual activities) | |||||||||||
| 4 | RCT | Serious a | Not serious | Not serious | Not serious | None | 9697/29,506 (32.9%) | 5078/24,407 (20.8%) | RR 1.59 (1.54 to 1.64) | 123 more per 1000 (from 112 more to 133 more) | ⨁⨁⨁◯ Moderate |
| Vaccination uptake (combined strategies vs single strategies) | |||||||||||
| 2 | RCT | Serious a | Not serious | Not serious | Serious b | None | 2695/6255 (43.1%) | 888/2085 (42.6%) | RR 1.01 (0.95 to 1.07) | 4 more per 1000 (from 21 fewer to 30 more) | ⨁⨁◯◯ Low |
| Hand hygiene compliance (combined strategies vs usual activities) (assessed with: opportunities for hand hygiene) | |||||||||||
| 4 | RCT | Serious a | Not serious | Not serious | Not serious | None | 529/1137 (46.5%) | 310/997 (31.1%) | RR 1.70 (1.03 to 2.83) | 218 more per 1000 (from 9 more to 569 more) | ⨁⨁⨁◯ Moderate |
| Hand hygiene compliance (combined strategies vs single strategies) (assessed with: opportunities for hand hygiene) | |||||||||||
| 2 | RCT | Serious a | Not serious | Not serious | Serious b | None | 1350/1992 (67.8%) | 726/1366 (53.1%) | RR 1.16 (0.99 to 1.36) | 85 more per 1000 (from 5 fewer to 191 more) | ⨁⨁◯◯ Low |
| Knowledge (combined strategies vs usual activities) | |||||||||||
| 1 | RCT | Very serious a,c | Not serious | Serious d | Not serious | None | 60 | 60 | - | MD 4.1 higher (3.39 higher to 4.81 higher) | ⨁⨁◯◯ Low |
| Knowledge (combined strategies vs single strategies) | |||||||||||
| 1 | RCT | Serious e | Not serious | Serious d | Serious b | None | Score improvement 17% (IQR 8 to 33%) versus 8% (IQR 8 to 33%); p = 0.27 | ⨁◯◯◯ Very low | |||
Note: CI confidence interval, RCT randomized controlled trial, RR risk ratio, MD mean difference
aProblems in blinding and allocation unconcealed
bNon-significant confidence interval
cSequence generation not adequate
dIndirect outcome for adherence to infection, prevention, and control measures
eIncomplete outcome data