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Background Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an e ective preventive measure. This is an update of a previously published review. Objectives To assess the short-and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection.

This is the unspecified version of the paper. This version of the publication may differ from the final published version. Permanent repository link: http://openaccess.city.ac.uk/360/ Link to published version: http://dx.