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“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]
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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
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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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
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