1192. A Visual Family Empowerment Tool Is Associated with Increased Healthcare Worker Hand Hygiene in a Pediatric Intensive Care Unit in Vietnam

Abstract

BackgroundHand hygiene (HH) is the most effective way to prevent healthcare-associated infections. The World Health Organization (WHO) recommends empowering patients and families to remind healthcare workers (HCWs) to perform HH. The effectiveness of patient and family empowerment tools in Southeast Asia is unknown.MethodsWe performed a prospective intervention study in an intensive care unit of a pediatric referral hospital in Vietnam. Using family and HCW input, we created a visual tool for families to use to remind HCWs to perform HH. For 2 weeks pre-intervention, we collected baseline data on HH performance, method (hand rub or soap and water), adequacy, HCW type (e.g., physician, nurse), and WHO 5 moments of HH using direct, unobtrusive observation. During a subsequent 3-week intervention period, consenting families were provided the visual tool and educated on its use to prompt HCW HH. Prospective collection of outcome data continued during the intervention period. The primary outcome was change in HCW HH between baseline and intervention periods. Multivariable logistic regression models were used to identify independent predictors of HH.ResultsA total of 2,014 pre-intervention and 2,498 intervention period HH opportunities were observed. During the intervention period, 73 families received visual reminder tools and education. Overall HCW HH was 46% pre-intervention, which increased to 73% in the intervention period (P < 0.001). Lowest HH adherence in both periods occurred after HCW contact with patient surroundings (WHO Moment 5; 16% pre-intervention and 24% intervention). In multivariable analyses, the odds of HCW HH during the intervention period were significantly higher than pre-intervention (OR 2.94 [95% CI 2.54 – 3.41], P < 0.001) after adjusting for observation room, HCW type, time of observation (weekday business hours vs. evening/weekend), and HH moment. Among completed HH opportunities, HH adequacy was >90% in both periods.ConclusionIntroduction of a visual empowerment tool was associated with significant improvement in HH adherence among HCWs in a Vietnamese pediatric intensive care unit. More research is needed to explore acceptability and barriers to the use of such tools in other low- and middle-income settings. Disclosures All authors: No reported disclosures.