463. Healthcare Workers Perceptions Regarding the Use of an Electronic Hand Hygiene Monitoring System at a VA Hospital

BACKGROUND: A cornerstone of healthcare-associated infection prevention is hand hygiene which has resulted in regulatory requirements to monitor hand hygiene compliance. Direct observation is the gold standard for hand hygiene compliance monitoring, but has several drawbacks. Electronic monitoring systems have begun to replace direct observation with several potential advantages, including larger sample size and more timely feedback. End user acceptance and adoption is a critical step to evidence-based practice implementation. To evaluate potential barriers and facilitators to adoption, we conducted a qualitative evaluation of nursing perceptions following a trial of an electronic hand hygiene compliance monitoring system. METHODS: We conducted four focus groups of 21 nursing staff on a medical/surgical inpatient unit at a tertiary care VA hospital. Nursing staff consisted of Registered Nurses, Nursing Assistants, and Health Technicians; of which there were 19 females and 2 males. Groups were audio recorded and tapes transcribed. Content analysis of transcriptions was undertaken to identify codes, categories, and themes. RESULTS: Themes identified as facilitators included: (1) unit champion; (2) electronic observation (vs. human observation); and (3) timely feedback. Themes identified as barriers included: (1) concern with data accuracy; (2) feasibility of frequent (daily) goal setting; and (3) staff knowledge of how system works. CONCLUSION: Nursing staff perceived electronic monitoring improved hand hygiene compliance. Staff verbalized negative perceptions with hand hygiene compliance monitoring but preferred electronic monitoring vs. human monitoring. Most barriers discussed revolved around the need to understanding how the electronic monitoring system works and need to believe the data are accurate. Implementation of this innovative technology will require extensive planning to address staff knowledge and understanding to ensure staff acceptance and adoption. DISCLOSURES: All authors: No reported disclosures.