Presentation Number 8-083 A CAUTI Bundle with a Twist

World Health Organization, 5 Moments, to characterize the types and frequency of HH opportunities and to monitor adherence to HH by various care givers. Clinical care givers were defined as physicians, nurses, nurse aides and respiratory, physical or occupational therapists and non-clinical care givers were defined as teachers, teachers aides, recreational support staff, environmental service workers, social workers, volunteers and adult visitors. Data analyses were descriptive. Comparisons of categorical data were performed using Pearson test. Results: We observed 865 HH opportunities of which a mean of 108 HH opportunities (range, 60 - 196) occurred per child during the 16 hours of observation. Prior to patient contact (39%) and prior to aseptic technique (1%) were the most and least common HH opportunities, respectively. Nurses and nurse aides had the highest number of HH opportunities (50%), while visitors; therapists; school staff; other staff and physicians were associated with 22%, 9%, 9%, 8% and 1% of HH opportunities, respectively. Overall HH adherence was 43% (27-65% per facility) and was significantly higher among clinical care providers than among non-clinical individuals (61% and 14%, respectively, P < 0.01). Adherence was highest after exposure to body fluids (66%) and lowest before patient contact (36%). Conclusions: Overall HH adherence was less than 50%, suggesting multiple opportunities for transmission of infectious agents and highlighting the need to improve HH practice in pediatric ECFs. Future studies should investigate strategies to improve HH adherence among the wide variety of care providers in this healthcare setting and assess their impact on healthcare-acquired