1201. Use of Remote Video Auditing to Monitor Adherence to High-Concern Isolation Guidelines in a Patient Infected With Candida auris; Use of Remote Video Auditing to Monitor Adherence to High-Concern Isolation Guidelines in a Patient Infected with Candida auris

Abstract

BackgroundPreventing the transmission of multidrug-resistant organisms requires strict adherence to isolation precautions. Candida auris (CA), an emerging multidrug-resistant fungal pathogen, can cause widespread and persistent contamination of environmental surfaces within healthcare facilities and lead to outbreaks. While direct observation (DO) with “secret shoppers” is traditionally used to monitor adherence to isolation precautions and personal protective equipment (PPE) use by healthcare personnel (HCP), this method is limited by logistic and cost issues. We studied the use of remote video auditing (RVA) to monitor adherence to isolation precautions in a patient with CA fungemia.MethodsThis is a cross-sectional study of HCP who were in contact with a single patient with CA fungemia. This patient was placed on standard and contact precautions and held in isolation in a single room in an acute care setting. Adherence to isolation precautions by HCP was observed by DO and RVA. RVA consisted of recording videos of HCP entering and exiting the room and auditing adherence using a standardized protocol by remotely-placed observers. Hand hygiene (HH) on entry and exit, the use of gloves and gowns upon entry, correct gown donning and the proper doffing sequence upon exit were observed by both methods. In the DO method, data were recorded per visit and not by entry/exit.ResultsRVA captured data for 120 visits by HCP (entry data [n = 62]; exit data [n = 58]) and DO captured data for 173 visits by HCP during 23 days. Table 1 shows the compliance rates determined by both methods. RVA yielded lower compliance rates on most measures than the DO method. Also, there were a higher number of missing observations in the DO groupConclusionRVA, when used to monitor adherence to isolation precautions in a high-concern CA patient, demonstrated lower compliance rates compared with DO and had fewer missing data elements. These results suggest that RVA is a novel monitoring method that may be a more precise alternative to DO for ensuring adherence to isolation precautions and the prevention of nosocomial transmission of high-concern pathogens such as CA. Disclosures All authors: No reported disclosures.