Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T17:02:12.500Z Has data issue: false hasContentIssue false
  • English
  • Français

“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

Published online by Cambridge University Press:  23 April 2021

Paritosh Prasad Open the ORCID record for Paritosh Prasad [Opens in a new window] ,
Lynne Brown ,
Shiyang Ma ,
Andrew McDavid ,
Andrew Rudmann ,
David Lent ,
Patricia Reagan-Webster ,
E. Kate Valcin ,
Paul Graman  and
Michael Apostolakos
Paritosh Prasad*
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Lynne Brown
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Shiyang Ma
Affiliation:
Department of Biostatistics, Columbia University, New York City, New York
Andrew McDavid
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Andrew Rudmann
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
David Lent
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Patricia Reagan-Webster
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
E. Kate Valcin
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Paul Graman
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
Michael Apostolakos
Affiliation:
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, New York
*
Author for correspondence: Paritosh Prasad, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates.

Design:

We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors.

Settings:

The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital.

Patients:

All adult inpatients with the exception of patients in the obstetrics unit.

Interventions:

A hospital-wide universal gloving protocol was initiated on January 1, 2016.

Results:

Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12–1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04).

Conclusion:

A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 11 , November 2021 , pp. 1351 - 1355
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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

Haque, M, Sartelli, M, McKimm, J, et al. Health care-associated infections—an overview. Infect Drug Resist 2018;11:2321–2333.10.2147/IDR.S177247CrossRefGoogle ScholarPubMed
Lessa, FC, Mu, Y, Bamberg, WM, Beldavs, ZG, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med 2015;372:825–834.CrossRefGoogle ScholarPubMed
Zhang, S, Palazuelos-Munoz, S, Balsells, EM, et al. Cost of hospital management of Clostridium difficile infection in United States—a meta-analysis and modelling study. BMC Infect Dis 2016;16:447.10.1186/s12879-016-1786-6CrossRefGoogle ScholarPubMed
Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000;356:1307–12.10.1016/S0140-6736(00)02814-2CrossRefGoogle ScholarPubMed
Pittet, D, Simon, A, Hugonnet, S, et al. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2004;141:1–8.10.7326/0003-4819-141-1-200407060-00008CrossRefGoogle Scholar
Johnson, S, Gerding, DN, Olson, MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990;88:137–140.10.1016/0002-9343(90)90462-MCrossRefGoogle ScholarPubMed
Chang, NN, Kates, AE, Ward, MA, et al. Association between universal gloving and health care associated infections: a systematic literature review and meta-analysis. Infect Control Hosp Epidemiol 2019;40:755–760.10.1017/ice.2019.123CrossRefGoogle ScholarPubMed
WHO best practices for injections and related procedures toolkit. Annex A, Indications for glove use in health care. https://www.ncbi.nlm.nih.gov/books/NBK138494/. Published March 2010. Accessed January 13, 2021.Google Scholar
Siegel, JD, Rhinehart, E, Jackson, M, et al. The Healthcare Infection Control Practices Advisory Committee, 2007 guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html. Accessed January 13, 2021.Google Scholar
Fuller, C, Savage, J, Besser, S, et al. “The dirty hand in the latex glove”: a study of hand hygiene compliance when gloves are worn. Infect Control Hosp Epidemiol 2011;32:1194–1199.10.1086/662619CrossRefGoogle ScholarPubMed
Bearman, GM, Marra, AR, Sessler, CN, et al. A controlled trial of universal gloving versus contact precautions for preventing the transmission of multidrug-resistant organisms. Am J Infect Control 2007;35:650–655.10.1016/j.ajic.2007.02.011CrossRefGoogle ScholarPubMed
Pereira, CA de B, Stern, J. Evidence and credibility: a full Bayesian test of precise hypothesis. Entropy 1999;1:104–115.Google Scholar
Bürkner, PC. brms: an R package for Bayesian multilevel models using Stan. J Statist Softw 2017;80:1–28.CrossRefGoogle Scholar
Kurunu, N, Kasahara, K, Mikasa, K. Hand hygiene compliance in universal gloving setting. Am J Infect Control 2017;45:830–834.10.1016/j.ajic.2017.02.024CrossRefGoogle Scholar
Bearman, G, Rosato, AE, Duane, TM, et al. Trial of universal gloving with emollient-impregnated gloves to promote skin health and prevent the transmission of multidrug-resistant organisms in a surgical intensive care unit. Infect Control Hosp Epidemiol 2010;31:491–497.10.1086/651671CrossRefGoogle Scholar
Kaufman, DA, Blackman, A, Conaway, MR, et al. Nonsterile glove use in addition to hand hygiene to prevent late-onset infections in pre-term infants: a randomized clinical trial. JAMA Pediatr 2014;168:909–916.10.1001/jamapediatrics.2014.953CrossRefGoogle Scholar
Yin, J, Schweizer, ML, Herwaldt, LA, et al. Benefits of universal gloving on hospital-acquired infections in acute-care pediatric units. Pediatrics 2013;131(5):e1515–20.10.1542/peds.2012-3389CrossRefGoogle ScholarPubMed
Supplementary material: Image

Prasad et al. supplementary material

Prasad et al. supplementary material 1

Download Prasad et al. supplementary material(Image)
Image 89.3 KB
Supplementary material: File

Prasad et al. supplementary material

Prasad et al. supplementary material 2

Download Prasad et al. supplementary material(File)
File 13.2 KB