1507Impact of Electronic Compliance Monitoring in an Ambulatory Pediatric Orthopedic Clinic

Background. Hand hygiene is one of the most crucial steps for preventing the transmission of illness; however rates of hand hygiene are persistently low. While most care occurs in ambulatory settings, there is little data on hand hygiene compliance rates in this environment. This study used an electronic hand hygiene compliance monitoring system to evaluate the impact of a comprehensive hand hygiene program on compliance rates in an ambulatory care clinic. Methods. A compliance activity monitoring system was installed to monitor all exam room entries and exits in the clinic and all hand hygiene events from soap or sanitizer dispensers. Compliance was measured as number of events / number of entries and exits. Baseline measurements were taken without HCW knowledge from February 9, 2013-February 24, 2013. The intervention, which included implementation of a comprehensive hand hygiene program, ran from March 1, 2013-May 23, 2013. A post-study assessment from May 24, 2013-August 15, 2013 determined whether changes in compliance rates were sustainable. Preand post-study questionnaires assessed HCW knowledge, attitudes, and practices regarding hand hygiene. Appropriate statistical comparisons were made. Results. There was a significant increase in the mean compliance rate from baseline to the intervention period, from 10.6% to 19.1%, representing an 80% increase. Additionally, the mean compliance rate in the post-study period was 13.6% which was significantly higher than the pre-study period, but a significant decline from the intervention period. Questionnaire data showed that HCWs perceived a significant increase in the amount of feedback they were given on their hand hygiene compliance, and observed a significant increase in the number of reminders to do hand hygiene. Conclusion. Implementation of a hand hygiene program that includes a compliance activity monitoring system resulted in a significant, sustained improvement in hand hygiene compliance rates. However, sustaining increased rates after the intervention period continues to be problematic. Further research will help better understand how to sustain increased hand hygiene compliance rates over extended time periods and to determine the impact of the compliance monitoring system on clinical outcomes, including infection rates. Disclosures. S. Edmonds, GOJO Industries: Employee, Salary J. Kirk, GOJO Industries: Employee, Salary