K-4094. Comparison of a Simplified “Before and After” Hand Hygiene (HH) Compliance Tool with a Detailed WHO-like Compliance Tool for the Accurate Assessment of HH Compliance
Session: Poster Session: Hand Hygiene: Compliance and Improvement
Tuesday, October 28, 2008: 12:00 AM
Room: Hall C
Background: HH compliance (HHC) is a key outcome measure in most HH culture-change programs. However, development of a HHC tool that is both easy to teach and use, while providing sufficient detail regarding high-risk HH “Moments” (HHMs) has proven difficult, especially in non-research settings. We compared the accuracy of a HHC assessment tool similar to the World Health Organization (WHO) “5 Moments” HH program (“Victorian tool”; VT) with a simplified “before-and-after” HHC tool (BAT). Methods: HHC was assessed concurrently in non-ICU wards using both the VT and BAT by two validated, independent observers for >1000 HHMs. To identify concordance/non-concordance between the two tools, HHMs were assessed according to whether they were associated with single patient care activities involving <2 HHMs (SAM) or a string of patient care activities involving multiple (>3) HHMs (MAM), and the type of WHO Moment involved.
Results: HHC was assessed during 56 sessions in 9 wards, involving 1033 and 1007 HHMs (VT and BAT, respectively) - overall HH compliance was 29% and 30%. In 39 (70%) sessions, involving 230 SAMs and 87 MAMs, VT and BAT could be accurately compared. As expected, VT and BAT described similar rates of HHC for SAMs (38% [91/237] vs 39% [93/239] respectively). For MAMs, VT recorded more HHMs than BAT (345 vs 318), but the overall HHC was identical (22%; 75/345 vs 71/318 HHMs, respectively). For high-risk HHMs (WHO Moments #2 and #3) among the entire study population, BAT recorded fewer HHMs than VT, but HHC rates were similar (#2: 5/22 [23%] vs 6/33 [18%]; #3: 14/35 [40%] vs 17/44 [39%]; BAT vs VT, respectively). Conclusions: Although VT identified more HHMs than the BAT, the overall rates of HHC for both tools were similar, both for SAMs and MAMs. The simple BAT may be a useful option for accurately assessing HHC in non-research clinical settings.
A Stewardson, MBBS1, C. Tullett2, F Wilson3, L. Jarvie2, M Grayson2 and  A. J. Stewardson, None., (1)Austin Health, Northcote, Australia, (2)Austin Health, (3)Western Hlth.

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