Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-26T03:49:11.456Z Has data issue: false hasContentIssue false
  • English
  • Français

Compliance With Routine Use of Gowns by Healthcare Workers (HCWs) and Non-HCW Visitors on Entry Into the Rooms of Patients Under Contact Precautions

Published online by Cambridge University Press:  02 January 2015

Farrin A. Manian  and
John J. Ponzillo
Farrin A. Manian*
Affiliation:
Division of Infectious Diseases, St. John's Mercy Medical Center, St. Louis, Missouri
John J. Ponzillo
Affiliation:
Department of Pharmacy, St. John's Mercy Medical Center, St. Louis, Missouri
*
Division of Infectious Diseases, St. John's Mercy Medical Center, St. Louis, MO 63141 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Modified contact precautions (MCP), defined as routine donning of isolation gowns (along with routine gloving) on entry into the rooms of patients under contact precautions, regardless of the likelihood of direct exposure to the patient or their immediate environment, were instituted at our medical center to reduce nosocomial transmission of common hospital pathogens.

Objectives.

To study compliance with MCP policy regarding routine gowning in intensive care units (ICUs) and general wards and to determine the relationship between gown and glove use in the care of patients under MCP in ICUs.

Design.

Prospective observational study from February 20, 2004, through January 8, 2005, involving 2,110 persons (1,504 healthcare workers [HCWs] and 606 non-HCW visitors).

Setting.

A 900-bed tertiary care teaching community hospital.

Results.

Overall compliance with routine gown use was observed for 1,542 persons (73%), including 1,150 HCWs (76%) and 392 visitors (65%) (odds ratio [OR], 1.8 [95% confidence interval {CI}, 1.4-2.2]; P < .001). Visitors in the ICUs (186 [91%] of 204) were more likely than visitors in the general wards (202 [51%] of 398) to comply with gown use (OR, 10 [95% CI, 6.0-17.0]; P < .001). In logistic regression analysis, independent predictors of gown compliance among HCWs were female sex (OR, 2.3 [95% CI, 1.8-3.0]; P < .001) and ICU setting (OR, 2.2 [95% CI, 1.7-2.9]; P < .001). In the ICUs, gown use was highly predictive of glove use among HCWs (positive predictive value, 95%).

Conclusion.

Improvement in compliance with gown use at our medical center will require more-intensive educational efforts targeted at male HCWs and at HCWs and visitors on general wards. In the care of ICU patients under MCP, HCW compliance with gown use may be used as a proxy for their compliance with glove use.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 3 , March 2007 , pp. 337 - 340
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control and Prevention, Hospital Infection Control Practices Advisory Committee. Prevention part II: recommendations for isolation precautions in hospitals. Available at: http://www.cdc.gov. Accessed August 3, 2005.Google Scholar
2.Slaughter, S, Hayden, MK, Nathan, C, et al. A comparison of the effect of universal use of gloves and gown with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 1996;125:448–456.Google Scholar
3.Afif, W, Huor, P, Brassard, P, Loo, V. Compliance with methicillin-resistant Staphylococcus aureus precautions in a teaching hospital. Am J Infect Control 2002;30:430–433.CrossRefGoogle ScholarPubMed
4.Jackson, M, Jarvis, WR, Scheckler, WE. HICPAC/SHEA-conflicting guidelines: what is the standard of care. Am J Infect Control 2004;8:504–511.Google Scholar
5.vander Mortel, T, Bourke, R, McLoughlin, J, Nonu, M, Reis, M. Gender influences handwashing rates in the critical care unit. Am J Infect Control 2001;29:395–399.Google Scholar
6.Sharir, R, Teitler, N, Lavi, I, Raz, L. High-level handwashing compliance in a community teaching hospital: a challenge that can be met! J Hosp Infect 2001;49:55–58.Google Scholar
7.Pittet, D. The Lowbury lecture: behaviour in infection control. J Hosp Infect 2004;58:1–13.Google Scholar