Research forum abstractPoster session 4: Administration244: Environmental Predictors of Hand Hygiene Compliance in the Emergency Department
Section snippets
Study Objective
Health care worker (HCW) hand hygiene (HH) prevents health care-associated infections, and studies show that environmental factors such as room visibility and availability of handwashing stations affect HH compliance. Little is known about how the unique emergency department (ED) work environment affects HH compliance. We aimed to determine the predictive value of HH opportunity characteristics, ED layout, and ED crowding on HH.
Methods
Observational HH data was collected prospectively at an urban, level one academic ED with approximately 57,000 annual visits. A trained research assistant directly observed HH in the ED in accordance with regulatory standards. HH compliance was defined as use of alcohol handrub or standard handwashing before and after contact with each patient or patient environment. A standardized data collection instrument was used to collect HH opportunity characteristics, ED layout, and ED crowding data. HH
Results
A total of 1475 HH opportunities were available for analysis with overall HH compliance of 88.2%. Reduced HH compliance was significantly associated with glove use (84.9% vs. 89.2%, p=0.03), OBS unit location (80.1 vs 89.5%, p=0.0002), and high visibility rooms (86.2% vs. 91.3%, p=0.003). A significant difference was demonstrated when comparing HH across health care provider types: MD (93.5%), nurse (88.0%), nurse's assistant (84.7%) and other HCW (75.6%), p<0.001. No significant bivariate
Conclusions
ED specific work environment characteristics such as hallway bed location or OBS unit location impacted HH compliance, while other environmental markers such as ED crowding were not associated with HH compliance. Individual EDs should consider what local work environment barriers exist to effective ED HH.