Eligibility criteria {10}
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The eligible hospital will meet the following criteria: classified as a ‘Public acute group A hospital’ by the Australian Institute of Health and Welfare (9), located in New South Wales, have an intensive care unit, have a minimum of 10 wards, and caring for adult patients (i.e. ≥ 18 years old) willing to participate in the study. Ten wards with > 20 beds, caring for adult patients, will be selected for the study.Hospitals will be excluded from the study if they do not meet the inclusion criteria. Hospitals may also be excluded from the study if within the study time frame (2023–2024) they are opening, closing or relocating, or implementing major environmental cleaning initiatives or changes.