Yeung 2011.

Study characteristics
Methods	Clustered‐RCT of a hand hygiene intervention involving pocket‐sized containers of alcohol‐based hand rub for the control of infections in long‐term care facilities. Staff hand hygiene adherence was directly observed, and residents' infections necessitating hospitalisation were recorded. After a 3‐month pre‐intervention period, long‐term care facilities (LTCFs) were randomised to receive pocket‐sized containers of alcohol‐based gel, reminder materials, and education for all HCWs (treatment group) or to receive basic life support education and workshops for all HCWs (control group). A 2‐week intervention period (1 to 15 April 2007) was followed by 7 months of postintervention observations.
Participants	6 out of 7 community‐based, private or semiprivate, residential LTCFs in Hong Kong agreed to participate and were randomised to: hand hygiene group (3 LTCFs, 73 nursing staff and 244 residents analysed); or control group (3 LTCFs, 115 nursing staff and 379 residents analysed). All were nursing homes serving an elderly population. All LTCFs were situated in different regions of Hong Kong, including urban and rural areas. The targets of the intervention were all full‐ and part‐time HCWs at these LTCFs. The LTCFs employed 3 types of HCWs: nurses, nursing assistants, and physiotherapists.
Interventions	Pocket‐sized containers of alcohol‐based gel, reminder materials, and education (intervention group) or basic life‐support education and workshop (control group). See Table 4 for details.
Outcomes	Rates of infection (requiring hospitalisation) Outbreaks Death due to infection Diagnoses of infection coded into 6 categories, all of which were common endemic infections in LTCFs: pneumonia, urinary tract infection, septicaemia, skin or soft‐tissue infection (including cellulitis or pressure sores), gastroenteritis, and fever. Infections recorded in death certificates were also included, regardless of whether the resident had been hospitalised. The causes of death were categorised as due to infection, not due to infection, or unknown. If the primary or the secondary diagnosis on the death certificate belonged to 1 of the 6 endemic infection categories, the death was coded as due to infection. No safety outcomes reported.
Notes	University and industry funded.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No details provided.
Allocation concealment (selection bias)	Unclear risk	No details provided.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unblinded study
Blinding of outcome assessment (detection bias) All outcomes	High risk	Unblinded study
Incomplete outcome data (attrition bias) All outcomes	Low risk	No loss to follow‐up
Selective reporting (reporting bias)	Unclear risk	No protocol available