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Nosocomial infections are a major public health risk more prevalent among vulnerable patients in intensive care units of lower and lower-middle income countries. Despite advances in health care, the prevalence of nosocomial infections is alarming. The reasons for these infections are multifactorial and include organisational, cultural and individual factors. This paper discusses the findings associated with research undertaken in six surgical intensive care units in Sri Lanka to evaluate the impact of an eHealth system prototype in contributing to the improvement of hand hygiene compliance and thereby reduction of nosocomial infections. Key findings include the necessity of reconsidering the way of calculating nosocomial infection rates, the importance of coupling interventions to feedbacks on outcomes and the role of the leaders as role models in inculcating positive behaviours.
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