CONCLUSIONS Both the proportion of improving HCWs and the median of individual HH improvement differed substantially among hospitals. Both measures were associated with the overall success of the intervention. However, the patterns and dynamics of individual HH compliance varied considerably among ICUs, and could potentially result in different risk of pathogen transmission. Being a nurse, a low individual baseline HH compliance, a lower ICU‐level activity index, and a favourable nurse‐to‐patient ratio were associated with a higher individual HH compliance improvement. Data on individual HH compliance could advance our understanding of improvement dynamics and inform better intervention strategies. Collecting individual level HH data on should be seriously considered in future HH research, especially in the design of interventions. DECLARATIONS Ethics approval and consent to participate The Medical Ethical Research Committee of the Utrecht University Medical Center, Utrecht, the Netherlands, decided that the study was not subject to the Medical Research Involving Human Subjects Act. All institutional review boards of the study hospitals approved of the study protocol. FUNDING The study was funded by the European Commission 7th Framework Programme. ACKNOWLEDGEMENTS We thank Sylvie Touveneau, Marie‐Noëlle Chraïti and Benedetta Allegranzi, who devoted themselves to the training of the on‐site investigators and study nurses in the workshops. Our gratitude extends also to the participating centres for collaborating in this study, especially the management and staff of the centres that allowed the individual compliance results to be recorded and that responded positively to the challenge to improve their hand hygiene and thus contributed to the increased safety of the patients in their care.
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