The aims of this study were to examine the impact of a comprehensive training programme in hand hygiene for nurse assistants (NAs) on their knowledge and compliance, as well as on the infection rate of nursing home residents. An intervention was conducted in northern Taiwan at three long-term care facilities. Forty NAs participated in a hand-hygiene training programme that included 1h of in-service classes and 30 min of hands-on training. Demographic data and NAs' knowledge and compliance regarding hand hygiene were collected and the infection rate of residents calculated. Three months after hand-hygiene training the NAs had significantly more knowledge (from 13.82 to 15.41, P<0.001) and better compliance (from 9.34% to 30.36%, P<0.001) than before the intervention. There was a reduction in residents' infection rate from 1.74% (December 2004 to February 2005) and 2.04% (June 2005 to August 2005) to 1.52% (December 2005 to February 2006) (P<0.001).