999. The Epidemiology of Hand Hygiene Compliance in the Era of Point of Care Hand Sanitizer
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
Background: Predictors of hand hygiene compliance have not been re-evaluated in the alcohol-based hand rinse (ABHR) era.   

Methods: Compliance data was collected at a teaching hospital over 2 years using direct observation.  A multimodal improvement initiative was ongoing during this period.  A generalized linear mixed model was used to evaluate the impact of predictors of compliance while correcting for clustering.

Results: We observed 7364 opportunities for hand hygiene among 3487 healthcare workers.  Hand hygiene compliance was 45% and did not vary over time.  Predictors of improved compliance on multivariate analysis included the indication for hand hygiene with higher compliance seen after body fluid exposure (OR 4.7, 95% CI 3.7 to 6.1) and after patient contact (OR 3.9, 95% CI 3.5 to 4.4) compared with hand hygiene prior to patient contact.  Glove use was also associated with higher compliance (OR 1.3, 95% CI 1.1. to 1.4).  A professional designation other than nurse/MD was associated with lower compliance (OR 0.72, 95% CI 0.61 to 0.86).  The number of hand hygiene opportunities per hour was not associated with lower compliance.  Higher ward level use of ABHR (vs. use of soap/water) was associated with better compliance (p=0.035). 

Conclusion: Hand hygiene compliance at our facility remains low, and did not improve despite a multimodal hand hygiene promotion program.  In the ABHR era a higher frequency of hand hygiene opportunities is no longer the primary barrier to achieving optimal hand hygiene compliance.  However, heterogeneous use of ABHR by ward may still provide a target for improvement.

Gerald Lebovic, PhD, Applied Health Research Centre, St. Michael's Hospital, Toronto, ON, Canada, Naureen Siddiqui, MSc, St. Michael's Hospital, Toronto, ON, Canada and Matthew Muller, MD, PhD, FRCPC, St.Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada


G. Lebovic, None

N. Siddiqui, None

M. Muller, None

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