In this episode, Brett and Martin discuss a cluster RCT from the Journal of Hospital Infection that took a very different approach. The researchers used social network analysis to identify the people operating room nurses naturally turned to for advice and support. Six of these informal influencers were then trained as peer champions—not as auditors or compliance police, but as positive role models who could encourage better practice through their existing relationships.
Over 12 months, hand hygiene compliance increased from 41.8% to 79.2% in the intervention group, compared with an increase from 42.6% to 59.3% with standard education. The study also reported improvements in knowledge and team climate.
But there is plenty to debate. Can we really attribute the reported reduction in surgical site infections to the intervention? And could we use the same idea to influence other IPC behaviours—perhaps getting the right people to model cleaning shared equipment, PPE use or other everyday safety behaviours?
Link to the paper is here:
Ye L, Jia X, Zhengyuan C, Dan Y, Jinjing Z, Nana W. Social network analysis-informed peer champions for hand hygiene in the operating room: a cluster randomised controlled trial. J Hosp Infect 2026;171:113–9. https://doi.org/10.1016/j.jhin.2026.03.003
The other paper we mention is here:
Seto WH, Ching TY, Yuen KY, Chu YB, Seto WL. The enhancement of infection control in-service education by ward opinion leaders. Am J Infect Control 1991;19(2):86–91. https://doi.org/10.1016/0196-6553(91)90044-d.
