We observed hygienic behavior as process outcome in a
pretest design and infection rates in an interrupted time
series. The study was performed in the level IIID NICU at
the Erasmus MC - Sophia Children’s Hospital in Rotterdam,
the Netherlands, from 1 January 2003 to 31 December
2006. The multifaceted intervention comprised an education
program, encouragement of key players to perform
correct hygienic behavior, and effecting a culture shift to
better hand hygiene