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257 Hospital-Wide Hand Hygiene Adherence Program and Correlation with Healthcare-Associated Infections

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Mark E. Rupp, MD , University of Nebraska Medical Center, Omaha, NE
Teresa Fitzgerald, RN , Nebraska Medical Center, Omaha, NE
James R. Anderson, PhD , University of Nebraska Medical Center, Omaha, NE
Nedra Marion, RN , Nebraska Medical Center, Omaha, NE
Lee Sholtz, RN , Nebraska Medical Center, Omaha, NE
Kate Tyner, RN , Nebraska Medical Center, Omaha, NE
Ann Adler, RN , Nebraska Medical Center, Omaha, NE
Valerie Smith, RN , Nebraska Medical Center, Omaha, NE
Marcia Beckerdite, RN , Nebraska Medical Center, Omaha, NE
Trevor VanSchooneveld, MD , University of Nebraska Medical Center, Omaha, NE

Background: Limited guidance is available to healthcare facilities regarding how best to measure hand hygiene (HH) compliance or what are appropriate benchmark rates.  In addition, there are insufficient data correlating HH and its impact on endemic healthcare-associated infections (HAI).

Objective: Accurately monitor and optimize institutional compliance with HH and correlate HH with HAIs.

Methods: Trained and validated observers on each patient care area submitted weekly HH compliance data via a secure, web-based, interactive database.  Unit HH compliance was compared to unit HAI rates.

Results: From May 2008 to September 2009, HH compliance surveillance was conducted on 7 critical care units, 9 inpatient units, and 25 outpatient units. In total, 31,366 opportunities for HH were observed. Overall, HCW HH compliance on inpatient units improved from 61.3% to 86.9% (p<0.05).  Quarterly HH compliance by HCW type is shown in Figure 1.

HH compliance for nurses was significantly greater than other HCW types.  From 9/08 to 9/09, overall inpatient unit specific HH compliance rates varied from 63% to 95%. Inpatient units were stratified according to HH compliance (63%-73%, 76%-82%, 86%-95%). The HAI rates (MRSA, VRE, CDI, CLA-BSI) between the groups were compared and no significant direct correlation between HH compliance and HAIs was noted.

Conclusions: Our HH surveillance system is an effective means to monitor HH compliance and our institution has achieved a good overall rate of HH compliance.  HAIs do not directly correlate with HH compliance and are likely influenced by a variety of confounding factors.