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Enhancing Hand Hygiene and Personal Protective Equipment Compliance in Veterans Affairs Hospitals

Sherman, Julia (2024) Enhancing Hand Hygiene and Personal Protective Equipment Compliance in Veterans Affairs Hospitals. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Background: Hospital-acquired infections (HAI), coupled with the rise of antimicrobial resistant organisms (MDRO), pose a serious risk to hospitalized patients. Strategies to reduce pathogen transmission in hospitals include hand hygiene and use of transmission-based precautions (TBP) for patients infected with a known pathogen. The VA Pittsburgh Healthcare System (VAPHS) has an institutional goal of 90% compliance with hand hygiene (HH) and personal protective equipment (PPE) policies for all units, but lack of specific compliance data and large portion of self-reported data, true compliance is unknown. Commonly used infection prevention observation tools do not include data collection for a variety of factors and patient demographic variables that may be associated with compliance to TBP and can be used to inform future infection prevention interventions. Methods: We created an observational tool with 15 variables for each patient observation that was used to collect observational compliance data before and after the implementation of a mass educational intervention. 237 observations were independently collected from June to September 2023 of healthcare workers (HCW) entering/exiting patient rooms that were on TBPs. Compliance percentages for each observation were calculated and assessed across pre- and post-samples for normality of distribution and differences between samples. Potential predictors of compliance percentage were identified using nonparametric Kruskal-Wallis tests and subsequent pairwise comparisons. Logistic regression models were created to identify main predictors of noncompliance to TBP (<90% compliance). Results: Following implementation of the educational intervention to 67 departments across VAPHS (~90% of staff), HCW compliance increased by an average of 25% in each compliance category, although still below 90% goal. Variables significantly associated with noncompliance were precaution type and contact type. The OR of noncompliance for patients on contact precautions compared to contact (+) is 2.53 (95% CI 1.12, 5.72) and OR for environmental contact compared to patient/environmental contact is 5.40 (95% CI 1.24, 23.56). Conclusions: The mandatory all staff educational intervention resulted in significant increases in compliance, despite room for improvement. Future interventions will center on the impact of precaution and contact types on healthcare worker compliance, holding significant public health implications.

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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sherman, Juliajus168@pitt.edujus168
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGlynn, Nancyepidnwg@pitt.eduepidnwg
Committee MemberWelburn, Sharonscw86@pitt.eduscw86
Committee MemberMartin, Eliseelise.martin1@va.gov
Committee MemberSundermann, Alexanderals412@pitt.eduals412
Date: 2 January 2024
Date Type: Publication
Defense Date: 6 December 2023
Approval Date: 2 January 2024
Submission Date: 14 December 2023
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 62
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Healthcare Associated Infections HAIs Hand hygiene Personal Protective Equipment Infection Prevention Transmission-Based Precautions
Date Deposited: 02 Jan 2024 17:34
Last Modified: 02 Jan 2024 17:34
URI: http://d-scholarship.pitt.edu/id/eprint/45701

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  • Enhancing Hand Hygiene and Personal Protective Equipment Compliance in Veterans Affairs Hospitals. (deposited 02 Jan 2024 17:34) [Currently Displayed]

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