Program Schedule

Improved intra-operative Hand Hygiene Compliance

Session: Poster Abstract Session: Multidrug-resistant Organisms: Epidemiology and Prevention
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Hospital acquired infections (HAIs) are a significant issue, impacting 10% of hospitalized patients and hand hygiene (HH) is widely believed to be one of the most important ways of decreasing HAI risk. Numerous studies have found compliance with HH to be low among healthcare workers, with the lowest levels of adherence being associated with limited access to HH while at the bedside.

Methods: Data were collected in the OR of a large teaching hospital in the Northeast.  A before and after study design was used and HH events during OR cases were measured.  In the pre group (Group 1), wireless data were collected from all the OR wall dispensers in each room (including in/out).  An event was captured electronically each time HH was performed.  In the post group (Group 2) the primary method for HH was the use of a personal alcohol handrub dispenser that was worn by all non-scrubbed OR personnel during the OR cases.

Results: This study examined the HH practices of non-scrubbed OR staff in a total of 133 case days.  There were 71 case days of HH using the wall dispensers (Group 1) and 62 case days using the personal alcohol handrub dispensers (Group 2).   

An independent sample t-test for equality of means was run to look for group differences on the outcome variable, the number of HH events per hour during surgical cases. A significant difference (p<0.001) was found in the number of hourly HH events between the two groups. Because the Levene’s test for equality of variance was significant,  the significance using “unequal variance assumed” of p<0.001 was reported.  Group 1 had a mean HH rate of 0.34 uses per hour with a standard deviation of 0.03.  Group 2 had a mean HH rate of 5.99 uses per hour with a standard deviation of 1.12.  Thus, the data support that OR staff who use a personal HH dispenser completed a significantly higher number of HH events during surgery than those using the wall dispenser for HH. 

Conclusion: The findings of this study align with much of the published research regarding HH in the acute care environment.  In fact, the rate in Group 1(0.34) is virtually the same as that previously reported for anesthesia providers (0.38) by Koff, et al (2009).  These findings provide additional support regarding the importance of having products or systems readily available at the bedside in order to improve healthcare worker HH compliance.

Randy Loftus, MD1, Donna Houston, RN2, Cindy Robison, RN2 and Matthew Koff, MD1, (1)Anesthesia, Dartmouth-Hitchcock Medical Center, Lebanon, NH, (2)Critical Care, Dartmouth-Hitchcock Medical Center, Lebanon, NH


R. Loftus, Sage Products: Investigator, Research grant and Research support

D. Houston, Sage Products: Investigator, Research grant and Research support

C. Robison, Sage Products: Investigator, Research grant and Research support

M. Koff, Sage Products: Investigator, Research grant and Research support

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