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1191. Hand Hygiene Education: Why Is It so Critical to Tissue Banking?

Abstract Background In the United States, the most commonly transplanted tissues are bones, tendons, skin, heart valves, vessels and corneas. Over two million tissue grafts are distributed each year.Efforts to advance tissue transplant safety are less defined compared with organ transplant, and continuously being improved and regulated by national agencies. Environmental contamination, postmortem translocation of microorganisms, cross-contamination, and tissue processing are critical components which can be prevented with hand hygiene education thus preventing the transmission of infectious diseases. Microorganisms from technicians’ skin can potentially result in infection and nontransplantable tissue. This is particularly true of regenerative tissue, such as Vivigen, that undergo no sterilization process. Methods A review was done of all 2018 ViviGen culture with these organisms: Bacillus, Cornebacterium, Diptheroids, Propionibacterium, Staphylococcus Coagulase negative, and Streptococcus viridians defined as Category 1. Results In 2018, 384 out of 1418 ViviGen donors were discarded due to positive cultures. Of the 384, 190 were due the presence of a Cat. 1 microorganism in post-processing cultures, for a discard rate of 17.6%. In these donors, preprocessing cultures were initially negative, thus indicating contamination was due to technician contamination. In the first quarter of 2019, and since implementation of Hand Hygiene education, we have already start to see a decline in acquisition of Cat 1 organism for a total reduction of 6% from Q1 of 2018 compared with 2019. Conclusion Tissue banking is a complex process of many steps to assure quality and safety of the tissue. Contamination is critical even when the microorganisms are considered low-virulent skin flora (i.e., Cat 1). This is especially important if these Cat 1 organisms are found in Post-processing cultures of grafts not terminally irradiated or sterilized. Implementation of proper hand hygiene education and aseptic techniques among tissue recovery and processing staff can significantly reduce the bioburden. Furthermore, a reduction in bioburden equates to higher likelihood in honoring the gift of donation in this selfless act of the donor and their loved one while also decreasing the financial loss due to culture results. Disclosures All authors: No reported disclosures.

compared with organ transplant, and continuously being improved and regulated by national agencies. Environmental contamination, postmortem translocation of microorganisms, cross-contamination, and tissue processing are critical components which can be prevented with hand hygiene education thus preventing the transmission of infectious diseases. Microorganisms from technicians' skin can potentially result in infection and nontransplantable tissue. This is particularly true of regenerative tissue, such as Vivigen, that undergo no sterilization process.

Methods.
A review was done of all 2018 ViviGen culture with these organisms: Bacillus, Cornebacterium, Diptheroids, Propionibacterium, Staphylococcus Coagulase negative, and Streptococcus viridians defined as Category 1.
Results. In 2018, 384 out of 1418 ViviGen donors were discarded due to positive cultures. Of the 384, 190 were due the presence of a Cat. 1 microorganism in post-processing cultures, for a discard rate of 17.6%. In these donors, preprocessing cultures were initially negative, thus indicating contamination was due to technician contamination. In the first quarter of 2019, and since implementation of Hand Hygiene education, we have already start to see a decline in acquisition of Cat 1 organism for a total reduction of 6% from Q1 of 2018 compared with 2019.
Conclusion. Tissue banking is a complex process of many steps to assure quality and safety of the tissue. Contamination is critical even when the microorganisms are considered low-virulent skin flora (i.e., Cat 1). This is especially important if these Cat 1 organisms are found in Post-processing cultures of grafts not terminally irradiated or sterilized. Implementation of proper hand hygiene education and aseptic techniques among tissue recovery and processing staff can significantly reduce the bioburden. Furthermore, a reduction in bioburden equates to higher likelihood in honoring the gift of donation in this selfless act of the donor and their loved one while also decreasing the financial loss due to culture results.
Disclosures. All authors: No reported disclosures. Hand 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.

A Visual Family Empowerment Tool Is Associated with Increased
Methods. We 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.
Results. A 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.
Conclusion. Introduction 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.