994. Hand Hygiene and Facial Protective Equipment Compliance in Dental, Dialysis, and Other Outpatient Clinics During Influenza Season:  A Model for Expansion
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
  • poster v6.pdf (438.0 kB)
  • Background:

    The Respiratory Protection Effectiveness Clinical Trial (ResPECT) compares the effectiveness of medical masks and N95 respirators for prevention of influenza and other viral respiratory infections (VRIs) in outpatient health care workers (HCWs) at sites in Baltimore, MD, Denver, CO and a large Veterans Administration (VA) system in New York, NY during a 12 week peak period of influenza season.


    160 HCWs were enrolled in 23 outpatient clinics in the VHA New York Harbor Healthcare system for the duration of the ResPECT Study. We compared HCW compliance with facial protective equipment (FPE) use, hand hygiene (HH), and glove use (GU) in dialysis and dental (D&D) clinics against other outpatient clinics with frequent exposure to VRI patients.  HH, FPE, GU practices of HCWs were recorded by trained observers using both a standardized paper record and HandyAudit, a novel software system capturing real-time observations.  The majority of observations were collected using laptops and computer tablets, with a standardized paper form used as a secondary recording option.


    Compared to other clinics, HCWs in D&D clinics were found to have significantly higher use of FPE during nearly all patient interactions.  However, there was no significant difference in HH or GU compliance.  Glove use was observed much more frequently than hand washing (see table).


    Dental and Dialysis Clinics Observations/Compliance (%)

    Other Outpatient Clinics  Observations/Compliance (%)


    Overall FPE use

    145/296 (48)

    23/823 (3)

    p =<.0001

    FPE use with VRI patients

    23/29  (79)

    16/30 (53)

    p =.06

    Eye protection use

    53/296 (18)

    0/823 (0)

    p = <.0001

    Hand hygiene

    29/78  (37)

    60/167 (36)

    p =.96

    Glove use

    63/86 (73)

    32/39 (82)

    p = .4



    We conclude that practices in D&D clinics conform better to accepted infection control recommendations for FPE use and that isolating and exporting these practices to other clinics is essential to protecting HCWs from acquiring and spreading VRI and proving which type(s) of FPE offer superior protection.

    Benedict J Frederick IV, BA, Chief of Staff, VA New York Harbor Healthcare System, New York, NY, Nicholas G Reich, PhD, Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, Connie Price, MD, Division of Infectious Diseases, Denver Health Medical Center, Denver, CO, Lewis Radonovich, MD, Office of Public Health, National Center for Occupational Health and Infection Control, Veterans Health Administration, Gainseville, FL, Trish M. Perl, MD, MSc, FIDSA, FSHEA, The Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Health System, Baltimore, MD; Johns Hopkins Medical Institutions, Baltimore, MD, Michael Simberkoff, MD, VA NY Harbor Healthcare System, New York, NY and ResPECT Study Team


    B. J. Frederick IV, None

    N. G. Reich, None

    C. Price, None

    L. Radonovich, None

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

    M. Simberkoff, None

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