LAUSR

Background Transmission-based precautions (TBP) are used by healthcare workers (HCWs) to prevent transmission of certain infectious agents. The purpose of this study is to evaluate if HCWs are more likely to be compliant with TBP during influenza season. Methods A TBP observation program was implemented in January, 2018 at a 1266-bed academic hospital. Infection prevention performed observations of compliance with contact and droplet precautions, on all inpatient units. Observers instructed to observe HCWs for personal protective equipment (PPE) compliance when caring for a patient with a designated isolation status. Observations were performed monthly on each unit. The study period was from 7/1/2018 through 9/30/2019, it was divided into: influenza season (12/20/2018 - 5/20/2019) and non-influenza season (7/1/2018 - 12/19/2018 and 5/21/2019 - 7/31/2019). Influenza season was defined as the time when the hospital microbiology laboratory reported increased positive influenza test. TBP observation compliance was compared using Mantel-Haenszel chi-square analysis. Results Between 7/1/2018 and 9/30/2019 there were 1789 TBP observations [1220 (68.2%) during non-influenza season and 569 (31.8%) during influenza season]. 608 (33.8%) TBP observations were non-compliant with more than one aspect of PPE use. Documented TBP non-compliance was no different for influenza season [178 (31.3%)] vs. non-influenza season [427 (35%), p = 0.122]. Non-compliant TBP observations were no different between seasons for contact precautions [169 (35.5%) during influenza season vs. 415 (36.7%) during non-influenza season, p=0.660] compared to droplet precautions [10 (6.9%) during influenza season vs 10 (6.0%) during non-influenza season, p=0.742]. Non-compliant TBP observations were significantly higher for contact precautions compared to droplet precautions [584 (36.3%) contact vs. 20 (6.5%) droplet precautions, p Conclusions Non-compliance with TBP did not differ between influenza and non-influenza season. Non-compliance with contact precautions was higher than with droplet precautions.