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738 Compliance to alcohol-based handrub and relationship with hydro-alcoholic solution consumption indicator: a multicenter assessment study in Northern France

Sunday, March 21, 2010: 11:15 AM
Regency VI-VII (Hyatt Regency Atlanta)
Delphine Verjat-Trannoy, PharmD , Cclin Paris Nord, Paris, France
Katiuska Miliani, MPH , Cclin Paris Nord, Paris, France
Sophie Nguyen, PharmD , Cclin Paris Nord, Paris, France
Mélanie Sitbon, PharmD , Cclin Paris Nord, Paris, France
Danièle Landriu, RN , Cclin Paris Nord, Paris, France
Pascal Astagneau, MD, PhD , Cclin Paris Nord, Paris, France
Background:

The hydro-alcoholic solution consumption indicator (HACI) is one of the five infection control indicators set up by the French Ministry of Health to be publicly reported annually by all hospitals. This indicator is likely to reflect preventive actions of cross-transmitted infections using hand hygiene. However, the issue of whether the volume of hydro-alcoholic solution consumed during a year reflects compliance with hand hygiene for healthcare staff is addressed.

Objective:

To evaluate whether hospitals in upper classes of HACI corresponded to higher compliance levels for hand hygiene.

Methods:

A multicenter observational practice assessment study of hand hygiene was carried out in 2006. Hospitals with at least 50% of clinical units which underwent the practice assessment and a minimum number of observations were selected taking into account hospitals size. For each hospital, the HACI score was calculated based on handrub products consumption per 1000 patients-days. According to this score, each hospital was ranked in 5 categories A to E. The average of compliance rates of hand hygiene and alcohol-based handrub were compared between categories of HACI using variance analysis.

Results:

Overall, 152 hospitals were selected for study analysis out of 225 which participated on a voluntary basis. For the 53 820 observations performed, the average of compliance rate was 72 % for hand hygiene and 38% for handrub use. Most of the 152 hospitals (80%) were ranked into HACI classes C and D corresponding to a score value from 10 to 70%. Significant relationship was found between compliance rates with handrub use and HACI indicator from 27.8% in the lower class to 44.3% in the upper class (p < 0.001). No significant relationship was found with compliance rates of hand hygiene whatever technique was used.

Conclusions:

The HCAI seems to reflect the handrub practices directly observed in healthcare staff. This indicator is then appropriate to be included in an infection control performance scoring system.