"The aim of PROHIBIT is to understand existing guidelines and practices to prevent healthcare associated infections (HAI) in European hospitals, identify factors that enable and prevent compliance with best practices, and test the effectiveness of interventions of known efficacy. The project will employ a mixed-methods approach combining the strengths of qualitative research, survey methods, observational and experimental designs. First, we will systematically review current guidelines on prevention of the most common HAIs within the EU, as well as schemes for surveillance and public reporting. Next, we will conduct a large-scale survey of what is actually being done in European hospitals, determining factors, and how these relate to bloodstream infection rates. The project will then focus on catheter-related bloodstream infection (CRBSI), a highly transmissible and reliably measured HAI, in a selected sample of European hospitals. In-depth interviews of healthcare staff and direct observation will be used to measure compliance with key prevention practices. A randomized effectiveness trial using a stepped wedge design will be conducted in intensive care units to determine the uptake and impact of 2 interventions (WHO hand hygiene protocol and so-called catheter bundle) on CRBSI as well as clinical and utilization outcomes. The information will be synthesized to develop recommendations for the EU, policy makers, managers and medical professionals to prevent HAI. Dissemination will include instructional workshops and on-line training materials."