“…890 In several other studies in which hand hygiene compliance was not monitored, multidisciplinary programmes that involved the introduction of an alcohol-based handrub were associated with a decrease in HCAI and cross-transmission rates. 429,489,645,735 The beneficial effects of hand hygiene promotion on the risk of cross-transmission have also been reported in surveys conducted in schools or day-care centres, 454,[891][892][893][894][895][896] as well as in community settings. 248,249,449,754,815,830,[897][898][899][900] While none of the studies conducted in the health-care setting represented randomized controlled trials, they provide substantial evidence that increased hand hygiene compliance is associated with reduced HCAI rates.…”