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Ten for the 11 criteria improved (p less then 0.05), as well as the composite signal (p=0.001) in every the regions of the nation, especially in the selection of hospitals participating at baseline. "Hand-hygiene (HH) infrastructure" reached 100% (baseline 97.9, p=0.001), "HH protocol" 96.9% (standard 92.9, p=0.001), "HH monitoring" 70% (standard 60.7, p less then 0.001) and "existence of antimicrobial prescription protocol" 80.7%(baseline 73.2; p less then 0.001), among others. The HAI rates