592. Assessment of Time Spent in the Room by Nurses and Nursing Assistants on a Pediatric Ward by Patient Isolation Status and Demographics

Abstract

BackgroundPublished reports have raised concern that RNs spend less time in hospital rooms of patients requiring isolation precautions. Other patient-related factors including race/ethnicity, primary language, and socio-economic factors reportedly influence the mean time spent in the room by RNs and certified nursing assistants (CNAs). At a children’s hospital the automated hand hygiene monitoring system (AHHMS) has motion sensors that detect patient room entry and exit and sensors that detect hand hygiene events. Time spent in patient rooms by RNs and CNAs was examined using AHHMS data captured for patients on a 24-bed pediatric hospital ward for multiple patient characteristics to evaluate factors influencing the duration of visits.MethodsRNs and CNAs routinely wore badges with infrared signal technology to monitor hand hygiene compliance, generating time-stamped data for room entries and exits, identified by user job category. Over a 30 day period, April 2016, RN and CNA time in the room was compared by patient characteristics including: length of stay, white yes/no, Hispanic yes/no, interpreter needed yes/no, and isolation status of contact-droplet, contact, or none. Mean minutes spent in the room for RNs and CNAs were evaluated with a random-effects linear model and gamma distribution.ResultsAdmissions for 220 patients occurred in the 24 rooms during the evaluation period; 88 RNs and 28 CNAs completed 18,641 time-stamped room entries and exits. The natural log of patient length of stay (hours) was significantly associated with increased RN and CNA minutes spent in the room (P < 0.001). Interpreter required was not associated with time in the room (P = 0.72), nor was race (P = 0.60), nor was Hispanic ethnicity (P = 0.81). There were no significant differences in time spent in the room for contact, contact-droplet, and no isolation (P = 0.92).ConclusionData derived from infrared signal AHHMS badges can provide insight into RN and CNA care patterns. Isolation status and patient demographics were unrelated to mean RN and CNA time in the room. Patient length of stay was the only predictor of increased nursing time spent providing direct patient care. These results contrast with previous reports demonstrating fewer nursing interactions based on patient demographics or isolation.Disclosures All authors: No reported disclosures.