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16) Pramipexole and significant changes during time was not seen in the control group. Table 3 Comparison of the median upper quartile (UQ) of subjective norms, intention, and behavior in the intervention and control groups before and after the intervention Discussion Although it is well accepted that hand hygiene is the most important behavior for reducing health care-associated infections, hand hygiene compliance is often low. The results of the present study did not show a statistically significant improvement in hand hygiene, and this finding is consistent with that reported by two major systematic reviews on the impact of interventions on hand hygiene compliance. These reviews include a 2010 Cochrane systematic review, which found insufficient evidence that hand hygiene interventions improve hand hygiene in the hospital setting,26 http://www.ncbi.nlm.nih.gov/books/NBK133371/ and a 2008 systematic review, which addressed studies evaluating hand hygiene interventions and health care-associated infections in acute and long-term care settings.27 Hence, we can say that high-quality evidence demonstrating the type of interventions that are most effective is lacking. Hand hygiene among health care staff is a challenge, and evidences show that despite this website the convenience and low cost, hand hygiene adherence behavior is less than expected among health care providers.8 Despite the presence of theory-based studies, which have been successful in improving hand hygiene behaviors, there are also some studies that have find more failed to achieve any change.28 Another study, which has a conclusion in line to our findings, concluded that hand hygiene interventions that target changes in attitudes, intentions, or self-reported practice are likely to fail in terms of changing behavior.29 The results of the present study showed that the mean score of BASNEF model constructs, which include attitude, enabling factors, subjective norms, and intention to behavior, increased significantly. Also, based on the BASNEF model, the results showed that educational intervention was not successful in improving hand hygiene adherence behaviors of the nurses. This finding is in line with that of Bikmorady et al,30 who also did not record a significant improvement in hand hygiene of the participants with soap and water after the trainings. Many texts claim that adherence improvement is temporary after educational interventions.31,32 In a study by Huang et al,33 4 months post-education, hand hygiene compliance significantly improved (P