2309. Promoting Healthcare Worker (HCW) Use of Personal Protective Equipment in Pediatric Ambulatory Settings
Session: Poster Abstract Session: Pediatric Healthcare Associated Infections
Saturday, October 6, 2018
Room: S Poster Hall
Background: Existing Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) guidelines promote HCW personal protective equipment (PPE) use to prevent respiratory virus transmission in pediatric clinics, however, adherence to recommendations is inconsistent. We evaluated the effectiveness of two strategies designed to cue HCW use of PPE in a pediatric primary care clinic.

Methods: We implemented two HCW-focused interventions: 1) prompt for front desk respiratory symptom screen with placement of droplet signs on exam room door for symptomatic patients, and 2) universal masking of healthcare workers during all patient encounters. Each intervention was implemented over a two-week period and preceded by a washout period. We obtained caregiver report of HCW hand hygiene and mask use during patient encounters and measured differences in the proportion of behavior observed compared to washout periods.

Results: We obtained 217 caregiver reports of clinician handwashing and mask use before, during and after the patient encounter. There was no difference in nurse pre- or post-encounter hand hygiene behavior before and after each intervention (Baseline 65.9%; Droplet: 73.3%, p=0.34; Universal masking: 77.5%, p=0.16 and Baseline 53.3%; Droplet: 66.6%, p=0.14; Universal masking: 55%, p=0.85, respectively). There was also no difference in pre- or post-encounter MD hand hygiene behavior before and after each intervention: (Baseline 86.9%; Droplet: 77.8, p=0.17; Universal masking: 87.5%; p=0.92 and Baseline 75%; Droplet: 71.1%, p=0.62; Universal masking: 80.0%; p=0.53, respectively). However, there was a significant difference in observed mask use during encounters among both RNs and MDs before and after each intervention: (Baseline:17.4%; Droplet: 44.4%,p <0.05; Universal masking: 42.5%, p<0.05 and Baseline: 20.6%; Droplet: 51.1%, p<0.05; Universal masking: 62.5%, p<0.05, respectively).

Conclusion: Respiratory symptom screening with visual prompts to use PPE and universal masking may not significantly impact hand hygiene behavior in a setting with high hand hygiene use but may increase mask use. Such interventions could provide a useful and low cost tool to help prevent the spread of respiratory viruses in primary care settings.

Folasade Odeniyi, MPH1, Samantha Hanley, BA1, Lauren Gianchetti, BA2, Anna Sharova, MPH1, Lori Handy, MD3, Susan E. Coffin, MD, MPH, FSHEA, FPIDS4 and Kristen Feemster, MD, MPH, MSHP5, (1)Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, (2)The Children's Hospital of Philadelphia, Philadelphia, PA, (3)Department of Pediatrics, Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, (4)Center for Pediatric Clinical Effectiveness, Pediatric Infectious Diseases Epidemiology and Antimicrobial Stewardship Research Group, Children's Hospital of Philadelphia, Philadelphia, PA, (5)Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA


F. Odeniyi, None

S. Hanley, None

L. Gianchetti, None

A. Sharova, None

L. Handy, None

S. E. Coffin, Merck, Inc.: Investigator , Research support .

K. Feemster, None

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.