Evaluating the impact of a hand hygiene campaign on improving adherence.

We monitored compliance with hand hygiene (HH) by direct observation in 3 hospitals in Cantabria, Spain before and after implementation of an HH informational campaign, separately analyzing the effect of a training program. We report that training plus an informational campaign doubled the probability of HH, whereas the informational campaign without training decreased adherence, acting as a deleterious factor in HH adherence.