307. Hand Hygiene among Healthcare Personnel during a Mild (2011-2012) and Moderate (2012-2013) Influenza Season
Session: Poster Abstract Session: Hand Hygiene in Healthcare Settings
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C


Background:   Hand hygiene (HH) is a primary measure to prevent spread of acute respiratory infections (ARI); however, performance frequency among healthcare personnel (HCP) is often less than optimal.  During the ARI season, HCP education focuses on enhanced need for HH and respiratory protection. A mild (2011-12) and moderately severe (2012-13) ARI season are compared to observe if increased ARI incidence results in greater HH performance in outpatient clinics with high exposure to ARI.

Methods:   To determine if study week, season, or ARI incidence drives compliance, HH observers collected compliance from HCPs participating in the Respiratory Protection Effectiveness Clinical Trial during the 2011-12 (YR1) and 2012-13 (YR2) respiratory seasons.  Within 3 geographically diverse medical centers (CO, MD, NY), WHO's 5 Moments HH compliance data was collected over 12 weeks each season.  Regional CDC influenza surveillance data (Regions 2, 3, & 8) determined season severity.  Linear regression determined the association of HH compliance in each site with study week, season, and regional weekly influenza incidence.

Results: A total of 3,276 HH observations were collected from 10,056 HCPs. Mean HH compliance rates did not differ significantly (p=0.07) between years at 30% (YR1) and 36% (YR2).  In both years, the highest HH compliance averaged across all sites occurred at the start of the study, coinciding with the onset of influenza season (38% and 54%, respectively). Figure 1 shows influenza isolates and HH compliance measures for CO (Region 8).  HH compliance was statistically significantly associated with week in CO (reduction of 2.6% per week 95% CI 3.8%, 1.4%) but not in other sites.  Regional influenza isolates and year were not associated with HH compliance in any of the three sites.

Figure 1.

Conclusion:   HH did not improve during the moderately severe influenza season (YR2).  HH compliance declined in one site with each progressive week in both years.  Increased ARI activity does not appear to motivate HH compliance. Other educational measures should be used to motivate HH compliance and novel strategies tested to increase HH compliance during ARI season.


Amy Irwin, DNP, RN, Medicine, Denver Health Medical Center, Denver, CO, Derek Cummings, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Kevin Silva, BS, Medicine, Denver Health & Hospital Authority, Denver, CO, Mary Bessesen, MD, VA Eastern Colorado Health Care System and University of Colorado School of Medicine, Denver, CO, Cynthia Gibert, MD, MSc, Washington, DC, VAMC, Washington, DC, Ann-Christine Nyquist, MD, MSPH, University of Colorado, Denver, CO, Trish M. Perl, MD, MSc, FIDSA, FSHEA, Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, Lewis Radonovich, MD, University of Florida College of Medicine, Gainesville, FL, Maria Rodriguez-Barradas, MD, Medicine- Infectious Disease, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, Michael Simberkoff, MD, VA NY Harbor Healthcare System, New York, NY, Connie Price, MD, Denver Health Medical Center, Denver, CO and The ResPECT Team


A. Irwin, None

D. Cummings, MedImmune: Consultant, Consulting fee

K. Silva, None

M. Bessesen, None

C. Gibert, None

A. C. Nyquist, None

T. M. Perl, None

L. Radonovich, None

M. Rodriguez-Barradas, None

M. Simberkoff, None

C. Price, None

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