Hand hygiene promotion delivered by change agents-Two attitudes, similar outcome.

Objective: To assess the effect of peer-identified change agents (PICAs) compared to management-selected change agents (MSCAs) on hand hygiene behavior in acute care.

Design: Randomized-controlled study.

Setting: Two internal medicine wards of a public, university-affiliated, tertiary-care hospital in Malaysia.

Hand hygiene - social network analysis of peer-identified and management-selected change agents.

Background: Hand hygiene compliance can be improved by strategies fostering collaborative efforts among healthcare workers (HCWs) through change agents. However, there is limited information about how change agents shape the social networks of work teams, and how this relates to organisational culture. The objectives of this study were to describe the influence of peer-identified change agents (PICAs) and management-selected change agents (MSCAs) on hand hygiene, perception of their leadership style by peers, and the role of the organisational culture in the process of hand hygiene promotion.