P-1095. Impact of QI Infection Prevention and Control (IPC) Interventions on Hand Hygiene compliance and Clostridioides difficile infections (CDI)

TL;DR

A hospital improved hand hygiene and reduced C. difficile infections through infection control interventions, but automated systems showed even better results.

Contribution

Demonstrated the effectiveness of multifaceted IPC interventions and compared them with automated systems for hand hygiene and CDI reduction.

Findings

Hand hygiene compliance increased from 69% to 91% after implementing IPC interventions.

C. difficile SIR decreased from 1.6 to 0.4 following the interventions.

Automated systems showed higher compliance (97%) and lower CDI rates (SIR 0) compared to manual methods.

Abstract

Despite using CDC diagnostic criteria and Antimicrobial stewardship interventions we witnessed an increase in local CDI.

Multifaceted IPC QI-interventions were implemented at our tertiary-care-center ICU Rehabilitation serving tristate-area of upper Midwest: manual-auditing, real-time observations for HCP hand-hygiene compliance; soap/sanitizer usage; education, hand-hygiene reminders in medical staff lounge, patient-rooms, nursing-stations, provider coaching and huddles focusing on nursing education. Pre-intervention-period (P1:4/1/2023- 9/30/2023) was compared with Intervention-period (P2:10/1/2023-3/31/2024). Additionally, *observation of automated hand hygiene system and a pilot Cross-sectional comparison was done for overall hand-hygiene compliance and CDI in our health-system (with manual auditing/monitoring) with a health-system with automated hand-hygiene monitoring [Spaulding Rehabilitation Center (Harvard Medical School, Boston, MA), using automated hand-hygiene system (Biovigil®) with inbuilt signaling/recording if improper hand-hygiene performed] (*supported by CDC PFL IPC Ambassador grant)

Hand-hygiene compliance rates for HCP increased from 69% [191/277 (compliant/observations)] during P1 to 91% (463/510) during P2 (P< 0.0001); with physicians increasing from 70% to 89% (p< 0.05); nurses 71% to 93% (p< 0.001); midlevel- providers 69% to 88% (p< 0.05); ancillary-staff 61% to 87% (p< 0.01)]. Hand-soap usage increased from 43% to 74% in P2 (p< 0.05). C. difficile SIR (Standardized Infection Ratio) decreased from 1.6 during P1 to 0.4 during P2 (p< 0.05). Comparatively, Spaulding Rehabilitation Center with automated hand-hygiene system had overall hand-hygiene compliance rates of 97% from 10/1/2023-3/31/24 (compared to 91% in our system) and C. difficile SIR of 0 compared with 0.4 in our system (p< 0.0001).

With interventions, we observed improved hand-hygiene compliance and decreased CDI at our institution, however, greater hand- hygiene compliance and lower SIR were noted with an automated system. Next steps would be to continue auditing/interventions and further evaluate applicability of automated-systems including cost-benefit analysis

All Authors: No reported disclosures