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

Abstract Background Despite using CDC diagnostic criteria and Antimicrobial stewardship interventions we witnessed an increase in local CDI. Methods 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) Results 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). Conclusion 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 Disclosures All Authors: No reported disclosures