993. Compliance among Health Care Workers
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H

Background: In health care settings, accurate compliance monitoring is vital to improving hand hygiene (HH) practices that facilitate infection control efforts. Within the context of The Respiratory Protection Clinical Effectiveness Trial (ResPECT), we measured the HH practices and the use of personal protective equipment (PPE) among health care workers (HCWs) at 53 outpatient health care settings and emergency departments (ED) at three sites – Baltimore, Denver, and New York.  

Methods: To determine compliance, random unannounced compliance was monitored weekly using the Handy Audit application a tablet based application where specific actions are evaluated and compliance is determined by an automated algorithm.  HH compliance was evaluated based on the World Health Organization's “5 moments”. HCWs were required to wear either N95 respirators or medical masks within 6 feet of patients exhibiting respiratory symptoms for 12 weeks. The researchers positioned themselves in areas of the clinics and EDs where HCWs could be easily viewed entering and exiting patient environments without interfering with clinic work.   

Results: 1820 total opportunities during 643 observation sessions were evaluated.  476 (26%) opportunities were compliant with a range of 8.7 to 39.3%.  Highest compliance rates occurred after patient contact (39.3% N=326) while the lowest compliance rates occurred before performing an aseptic technique (8.7%, N=23). Compliance varied by profession included social workers (100%, N=6) and IV team/blood collection (51.5%, N=91) while the lowest compliance rates included patient transporters (0%, N=3) and front desk/registration workers (15.7%, N=396). Compliance decreased from 29.9 to 20.4% over the active study period when all three sites were recording data.


Conclusion: After 12 weeks of compliance monitoring, overall observed compliance rates are relatively low. Low observed compliance in outpatient settings may be attributed to inability of researchers to view patient contact where hand hygiene most frequently occurs.  Additional research is needed.

Jenna Los, BA, Medicine, Johns Hopkins University, Baltimore, MD, Connie Price, MD, Denver Health Medical Center, Denver, CO, Michael Simberkoff, MD, VA NY Harbor Healthcare System, New York, NY, Lewis Radonovich, MD, North Florida/South Georgia Veterans Health System, Gainesville, FL, Nicholas G. Reich, PhD, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, Trish M. Perl, MD, MSc, FIDSA, FSHEA, Johns Hopkins Medical Institutions, Baltimore, MD and ResPECT Study Team


J. Los, None

C. Price, None

M. Simberkoff, None

L. Radonovich, None

N. G. Reich, None

T. M. Perl, Merck: Grant Investigator, Research grant
Hospira: Board Member, Consulting fee

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