No doubt your hospital has an infection control committee, signs for handwashing, sterile showers, plasma arc denudes, etc. and your e-mail box is filled with Journey to Zero or Destination: Excellence spam.
Unfortunately, it didn’t seem to work up at Mayo. They had ICUs where they put signs up trying to inspire more barrier precautions and hand hygiene, they did more surveillance and topical intranasal antibiotics – and the intervention group valiantly tried to obey. They were somewhat poor in their compliance with suggested barrier precautions, but they were used far more often than in the control clusters – and they found no differences in any of their measures of MRSA or VRE colonization or infection following their intervention.
I will certainly not argue against cleanliness and godliness, but I am impressed they published this lovely negative study to confound us and make us think about how we should go about focusing our resources effectively.