Results: All study hospitals had changed their policies and procedures and provided products in compliance with Guideline
recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline.
However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene
rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals
with higher rates of hand hygiene (P , .001). No impact of Guideline implementation or hand hygiene compliance on other HAI
rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely
to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline