1097. Healthcare Worker Hand Contamination at Critical Moments in Outpatient Care Settings
Session: Poster Abstract Session: Infection Prevention: Hand Hygiene and PPE
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Network APIC Poster Final.pdf (660.4 kB)
  • Background: The delivery of healthcare in outpatient settings has steadily risen over the past 40 years.  The risk of infection in these settings is considered to be low. However, the increasing severity of illness and complexity of care in outpatient settings creates the need to reexamine the transmission of pathogens in these settings. 

    Methods: Using an American Society for Testing and Materials (ASTM) hand sampling methodology, healthcare workers from four wound care facilities were sampled during 46 patient care encounters to determine the presence of healthcare-associated pathogens on their hands at key moments of care (WHO Moments 2 and 3 for hand hygiene). Hands were tested for MRSA, VRE, Acinetobactor, and C.difficile.  Glove use was recorded during patient care. 

    Results: Healthcare workers acquired a pathogen on their hands during 28.3% of all the patient care encounters.  Hands sampled before a clean or aseptic procedure (Moment 2) and hands sampled after body fluid exposure risk (Moment 3) were both contaminated in 17.4% of all instances.  Hand contamination occurred in 19.6% of instances where healthcare workers wore gloves during care compared to 14.6% when healthcare workers were ungloved.

    Table 1: Breakdown of healthcare workers hand contamination during patient care encounters, % (n) 

    Pathogens

    Moment 2 Events

    (n = 46)

    Moment 3 Events

    (n = 46)

    Patient Care Encounters

    (n = 46)

    MRSA

    4.4% (2)

    10.9% (5)

    13.0% (6)

    VRE

    2.2% (1)

    0.00% (0)

    2.2% (1)

    Acinetobacter

    0.0% (0)

    2.2% (1)

    2.2% (1)

    C. difficile

    10.9% (5)

    4.4% (2)

    15.2% (7)

    Any Pathogen

    17.4% (8)

    17.4% (8)

    28.3% (13)

    Conclusion: The risk of pathogen transmission in outpatient settings must be reconsidered because of the significant contamination found on healthcare workers hands.  Attention to hand hygiene compliance at critical moments during patient care is supported by this study. Glove use did not prevent contamination of the hands reaffirming the need for hand hygiene when donning or doffing gloves.

    Jane Kirk, MSN RN CIC, Healthcare, GOJO Industries, Akron, OH and ICP HH Network, Akron, OH

    Disclosures:

    J. Kirk, GOJO Industries Inc: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.