The Impact of Gown-Use Requirement on Hand Hygiene Compliance
Background. Hand hygiene compliance remains low, despite its effectiveness in preventing infections. Gowns are routinely used to reduce dissemination of organisms within hospitals. Use of gowns is time consuming and costly, and their effectiveness, compared with that of hand hygiene alone, is debate...
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| Veröffentlicht in: | Clinical infectious diseases 2006-02, Vol.42 (3), p.370-376 |
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| creator | Golan, Yoav Doron, Shira Griffith, John El Gamal, Hesham Tanios, Maged Blunt, Keri Barefoot, Laurie Bloom, Judy Gamson, Katelyn Snydman, Laura K. Hansjosten, Karen Elnekave, Eldad Nasraway, Stanley A. Snydman, David R. |
| description | Background. Hand hygiene compliance remains low, despite its effectiveness in preventing infections. Gowns are routinely used to reduce dissemination of organisms within hospitals. Use of gowns is time consuming and costly, and their effectiveness, compared with that of hand hygiene alone, is debated. Among the arguments supporting a gown-use requirement is the potential to boost awareness of infection control, leading to improved hand hygiene compliance. Methods. Hand hygiene compliance was recorded in a 14-month crossover trial comparing compliance at 2 intensive care units during periods with and without a gown-use requirement. Results. During 170 h of observation, 1619 hand hygiene opportunities were recorded. Compliance was 10% before care was given and 36% after care was given. Compliance with glove and gown use was 62% and 63%, respectively. After-care hand hygiene compliance for nurses, physicians, and therapists was 40%, 38%, and 22%, respectively. Compliance after patient contact, body fluid contact, and other in-room activity was 42%, 48%, and 22%, respectively. For periods with and without a gown-use requirement, overall after-care compliance (37% vs. 34%) and rates by personnel and activity type were similar. In the subgroup of patients on contact precautions, hand hygiene compliance during the period with a gown-use requirement versus the period without a gown-use requirement was 11% versus 10% (P = .85) before care was given and 45% versus 39% (P = .09) after care was given. In this subgroup, after adjustment for type of in-room activity, medical personnel, intensive care unit, and observer, the predicted after-care hand hygiene compliance during periods with and without a gown-use requirement was 48% versus 41% (P = .02). Conclusions. The hypothesis that a gown-use requirement might improve hand hygiene compliance in the intensive care unit could not be confirmed. In the subgroup of patients on contact precautions, improvement in hand hygiene compliance associated with the gown-use requirement was small and did not affect precare rates. |
| doi_str_mv | 10.1086/498906 |
| format | Article |
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Hand hygiene compliance remains low, despite its effectiveness in preventing infections. Gowns are routinely used to reduce dissemination of organisms within hospitals. Use of gowns is time consuming and costly, and their effectiveness, compared with that of hand hygiene alone, is debated. Among the arguments supporting a gown-use requirement is the potential to boost awareness of infection control, leading to improved hand hygiene compliance. Methods. Hand hygiene compliance was recorded in a 14-month crossover trial comparing compliance at 2 intensive care units during periods with and without a gown-use requirement. Results. During 170 h of observation, 1619 hand hygiene opportunities were recorded. Compliance was 10% before care was given and 36% after care was given. Compliance with glove and gown use was 62% and 63%, respectively. After-care hand hygiene compliance for nurses, physicians, and therapists was 40%, 38%, and 22%, respectively. Compliance after patient contact, body fluid contact, and other in-room activity was 42%, 48%, and 22%, respectively. For periods with and without a gown-use requirement, overall after-care compliance (37% vs. 34%) and rates by personnel and activity type were similar. In the subgroup of patients on contact precautions, hand hygiene compliance during the period with a gown-use requirement versus the period without a gown-use requirement was 11% versus 10% (P = .85) before care was given and 45% versus 39% (P = .09) after care was given. In this subgroup, after adjustment for type of in-room activity, medical personnel, intensive care unit, and observer, the predicted after-care hand hygiene compliance during periods with and without a gown-use requirement was 48% versus 41% (P = .02). Conclusions. The hypothesis that a gown-use requirement might improve hand hygiene compliance in the intensive care unit could not be confirmed. In the subgroup of patients on contact precautions, improvement in hand hygiene compliance associated with the gown-use requirement was small and did not affect precare rates.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/498906</identifier><identifier>PMID: 16392083</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Aftercare ; Biological and medical sciences ; Body fluids ; Compliance ; Critical care ; Dresses ; Effectiveness ; Epidemiology. Vaccinations ; Evening gloves ; General aspects ; Guideline Adherence - standards ; Hand Disinfection - standards ; Hands ; Humans ; Hygiene ; Infection Control ; Infections ; Infectious diseases ; Intensive care units ; Intensive Care Units - standards ; Major Articles ; Medical personnel ; Medical sciences ; Multivariate Analysis ; Odds Ratio ; Patient compliance ; Physicians ; Protective Clothing - standards</subject><ispartof>Clinical infectious diseases, 2006-02, Vol.42 (3), p.370-376</ispartof><rights>Copyright 2006 The Infectious Diseases Society of America</rights><rights>2006 by the Infectious Diseases Society of America 2006</rights><rights>2006 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Feb 1, 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-a4bf9ada0de51f910bea1d6d3837683955b504fe915486685efcf8e7a67e4fb33</citedby><cites>FETCH-LOGICAL-c451t-a4bf9ada0de51f910bea1d6d3837683955b504fe915486685efcf8e7a67e4fb33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4484607$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4484607$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27915,27916,58008,58241</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17518468$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16392083$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Golan, Yoav</creatorcontrib><creatorcontrib>Doron, Shira</creatorcontrib><creatorcontrib>Griffith, John</creatorcontrib><creatorcontrib>El Gamal, Hesham</creatorcontrib><creatorcontrib>Tanios, Maged</creatorcontrib><creatorcontrib>Blunt, Keri</creatorcontrib><creatorcontrib>Barefoot, Laurie</creatorcontrib><creatorcontrib>Bloom, Judy</creatorcontrib><creatorcontrib>Gamson, Katelyn</creatorcontrib><creatorcontrib>Snydman, Laura K.</creatorcontrib><creatorcontrib>Hansjosten, Karen</creatorcontrib><creatorcontrib>Elnekave, Eldad</creatorcontrib><creatorcontrib>Nasraway, Stanley A.</creatorcontrib><creatorcontrib>Snydman, David R.</creatorcontrib><title>The Impact of Gown-Use Requirement on Hand Hygiene Compliance</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Background. Hand hygiene compliance remains low, despite its effectiveness in preventing infections. Gowns are routinely used to reduce dissemination of organisms within hospitals. Use of gowns is time consuming and costly, and their effectiveness, compared with that of hand hygiene alone, is debated. Among the arguments supporting a gown-use requirement is the potential to boost awareness of infection control, leading to improved hand hygiene compliance. Methods. Hand hygiene compliance was recorded in a 14-month crossover trial comparing compliance at 2 intensive care units during periods with and without a gown-use requirement. Results. During 170 h of observation, 1619 hand hygiene opportunities were recorded. Compliance was 10% before care was given and 36% after care was given. Compliance with glove and gown use was 62% and 63%, respectively. After-care hand hygiene compliance for nurses, physicians, and therapists was 40%, 38%, and 22%, respectively. Compliance after patient contact, body fluid contact, and other in-room activity was 42%, 48%, and 22%, respectively. For periods with and without a gown-use requirement, overall after-care compliance (37% vs. 34%) and rates by personnel and activity type were similar. In the subgroup of patients on contact precautions, hand hygiene compliance during the period with a gown-use requirement versus the period without a gown-use requirement was 11% versus 10% (P = .85) before care was given and 45% versus 39% (P = .09) after care was given. In this subgroup, after adjustment for type of in-room activity, medical personnel, intensive care unit, and observer, the predicted after-care hand hygiene compliance during periods with and without a gown-use requirement was 48% versus 41% (P = .02). Conclusions. The hypothesis that a gown-use requirement might improve hand hygiene compliance in the intensive care unit could not be confirmed. In the subgroup of patients on contact precautions, improvement in hand hygiene compliance associated with the gown-use requirement was small and did not affect precare rates.</description><subject>Aftercare</subject><subject>Biological and medical sciences</subject><subject>Body fluids</subject><subject>Compliance</subject><subject>Critical care</subject><subject>Dresses</subject><subject>Effectiveness</subject><subject>Epidemiology. Vaccinations</subject><subject>Evening gloves</subject><subject>General aspects</subject><subject>Guideline Adherence - standards</subject><subject>Hand Disinfection - standards</subject><subject>Hands</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Infection Control</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Intensive care units</subject><subject>Intensive Care Units - standards</subject><subject>Major Articles</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Patient compliance</subject><subject>Physicians</subject><subject>Protective Clothing - standards</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kF9rFDEUxYNUbF31E4iMQn0bmzT_H_ogS9strrSVLYgvITNzY2c7M5kmM-h--0Zm2YWC5CEh58e59xyE3hH8hWAlTphWGosX6IhwKnPBNTlIb8xVzhRVh-h1jGuMCVGYv0KHRFB9ihU9Qmere8iu2t6WQ-Zddun_dPldhOwHPI51gBa69N9lC9tV2WLzu4YOsrlv-6a2XQlv0Etnmwhvt_cM3V2cr-aLfHl9eTX_usxLxsmQW1Y4bSuLK-DEaYILsKQSFVVUCkU15wXHzIEmnCkhFAdXOgXSCgnMFZTO0OfJtw_-cYQ4mLaOJTSN7cCP0QgpcDo6gZ-egWs_hi7tZk6J1lIwxvZuZfAxBnCmD3Vrw8YQbP61aaY2E_hh6zYWLVR7bFtfAo63gI2lbVxIpdRxz0lOFEsJZ-jjxPmx__-w9xOzjoMPO4qx5IBlkvNJruMAf3eyDQ8pPZXcLH7-MstvN-q7VitzS58A48Sb-Q</recordid><startdate>20060201</startdate><enddate>20060201</enddate><creator>Golan, Yoav</creator><creator>Doron, Shira</creator><creator>Griffith, John</creator><creator>El Gamal, Hesham</creator><creator>Tanios, Maged</creator><creator>Blunt, Keri</creator><creator>Barefoot, Laurie</creator><creator>Bloom, Judy</creator><creator>Gamson, Katelyn</creator><creator>Snydman, Laura K.</creator><creator>Hansjosten, Karen</creator><creator>Elnekave, Eldad</creator><creator>Nasraway, Stanley A.</creator><creator>Snydman, David R.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20060201</creationdate><title>The Impact of Gown-Use Requirement on Hand Hygiene Compliance</title><author>Golan, Yoav ; Doron, Shira ; Griffith, John ; El Gamal, Hesham ; Tanios, Maged ; Blunt, Keri ; Barefoot, Laurie ; Bloom, Judy ; Gamson, Katelyn ; Snydman, Laura K. ; Hansjosten, Karen ; Elnekave, Eldad ; Nasraway, Stanley A. ; Snydman, David R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-a4bf9ada0de51f910bea1d6d3837683955b504fe915486685efcf8e7a67e4fb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aftercare</topic><topic>Biological and medical sciences</topic><topic>Body fluids</topic><topic>Compliance</topic><topic>Critical care</topic><topic>Dresses</topic><topic>Effectiveness</topic><topic>Epidemiology. Vaccinations</topic><topic>Evening gloves</topic><topic>General aspects</topic><topic>Guideline Adherence - standards</topic><topic>Hand Disinfection - standards</topic><topic>Hands</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Infection Control</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Intensive care units</topic><topic>Intensive Care Units - standards</topic><topic>Major Articles</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Patient compliance</topic><topic>Physicians</topic><topic>Protective Clothing - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Golan, Yoav</creatorcontrib><creatorcontrib>Doron, Shira</creatorcontrib><creatorcontrib>Griffith, John</creatorcontrib><creatorcontrib>El Gamal, Hesham</creatorcontrib><creatorcontrib>Tanios, Maged</creatorcontrib><creatorcontrib>Blunt, Keri</creatorcontrib><creatorcontrib>Barefoot, Laurie</creatorcontrib><creatorcontrib>Bloom, Judy</creatorcontrib><creatorcontrib>Gamson, Katelyn</creatorcontrib><creatorcontrib>Snydman, Laura K.</creatorcontrib><creatorcontrib>Hansjosten, Karen</creatorcontrib><creatorcontrib>Elnekave, Eldad</creatorcontrib><creatorcontrib>Nasraway, Stanley A.</creatorcontrib><creatorcontrib>Snydman, David R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Golan, Yoav</au><au>Doron, Shira</au><au>Griffith, John</au><au>El Gamal, Hesham</au><au>Tanios, Maged</au><au>Blunt, Keri</au><au>Barefoot, Laurie</au><au>Bloom, Judy</au><au>Gamson, Katelyn</au><au>Snydman, Laura K.</au><au>Hansjosten, Karen</au><au>Elnekave, Eldad</au><au>Nasraway, Stanley A.</au><au>Snydman, David R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Gown-Use Requirement on Hand Hygiene Compliance</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2006-02-01</date><risdate>2006</risdate><volume>42</volume><issue>3</issue><spage>370</spage><epage>376</epage><pages>370-376</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background. Hand hygiene compliance remains low, despite its effectiveness in preventing infections. Gowns are routinely used to reduce dissemination of organisms within hospitals. Use of gowns is time consuming and costly, and their effectiveness, compared with that of hand hygiene alone, is debated. Among the arguments supporting a gown-use requirement is the potential to boost awareness of infection control, leading to improved hand hygiene compliance. Methods. Hand hygiene compliance was recorded in a 14-month crossover trial comparing compliance at 2 intensive care units during periods with and without a gown-use requirement. Results. During 170 h of observation, 1619 hand hygiene opportunities were recorded. Compliance was 10% before care was given and 36% after care was given. Compliance with glove and gown use was 62% and 63%, respectively. After-care hand hygiene compliance for nurses, physicians, and therapists was 40%, 38%, and 22%, respectively. Compliance after patient contact, body fluid contact, and other in-room activity was 42%, 48%, and 22%, respectively. For periods with and without a gown-use requirement, overall after-care compliance (37% vs. 34%) and rates by personnel and activity type were similar. In the subgroup of patients on contact precautions, hand hygiene compliance during the period with a gown-use requirement versus the period without a gown-use requirement was 11% versus 10% (P = .85) before care was given and 45% versus 39% (P = .09) after care was given. In this subgroup, after adjustment for type of in-room activity, medical personnel, intensive care unit, and observer, the predicted after-care hand hygiene compliance during periods with and without a gown-use requirement was 48% versus 41% (P = .02). Conclusions. The hypothesis that a gown-use requirement might improve hand hygiene compliance in the intensive care unit could not be confirmed. In the subgroup of patients on contact precautions, improvement in hand hygiene compliance associated with the gown-use requirement was small and did not affect precare rates.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>16392083</pmid><doi>10.1086/498906</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aftercare Biological and medical sciences Body fluids Compliance Critical care Dresses Effectiveness Epidemiology. Vaccinations Evening gloves General aspects Guideline Adherence - standards Hand Disinfection - standards Hands Humans Hygiene Infection Control Infections Infectious diseases Intensive care units Intensive Care Units - standards Major Articles Medical personnel Medical sciences Multivariate Analysis Odds Ratio Patient compliance Physicians Protective Clothing - standards |
| title | The Impact of Gown-Use Requirement on Hand Hygiene Compliance |
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