Skip to main content

Compliance with the implementation of an ICU cluster-randomized trial assessing the benefits and potential harms of universal glove and gowning

Introduction

The Benefits of Universal Glove and Gowning (BUGG) study is a cluster-randomized trial to evaluate the use of wearing gloves and gowns for all patient contact in the ICU. The primary outcome is VRE and MRSA acquisitions; secondary outcomes include frequency of healthcare worker visits, infection rates, hand hygiene compliance and adverse events.

Methods

We enrolled 20 ICUs in 15 states. ICUs collected nasal and perianal swabs on all patients at admission and discharge/transfer. After a 3-month baseline period, 10 units were randomized to the intervention arm and required to wear gloves and gowns for all patient contact. An intervention toolkit was created based on site feedback and compliance reports. Swab collection compliance was fed back and discussed during site conference calls on a weekly basis. Site coordinators monitored compliance with gloves and gowns, hand hygiene and frequency of HCW visits and reviewed patient charts for adverse events.

Results

During the 12-month study period, 100,210 swabs were collected. After the baseline period, we were able to achieve and maintain swab compliance rates between 85 and 97%. Monthly discharge compliance increased by 21% by the beginning of the intervention period (Figure 1). Observers found 86% compliance with universal glove and gowning over 1,242 30-minute observation periods (Figure 1). Ninety charts at each site were reviewed for adverse events.

Figure 1
figure1

Swab collection and gown/glove compliance.

Conclusion

Over a diverse group of US hospitals, we achieved high compliance with surveillance cultures and implementing universal gloving and gowning was achieved quickly with high compliance.

Author information

Affiliations

Authors

Corresponding author

Correspondence to D Kett.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Kett, D., Morgan, D., Pineles, L. et al. Compliance with the implementation of an ICU cluster-randomized trial assessing the benefits and potential harms of universal glove and gowning. Crit Care 17, P54 (2013). https://doi.org/10.1186/cc11992

Download citation

Keywords

  • Hand Hygiene
  • Baseline Period
  • Hand Hygiene Compliance
  • Surveillance Culture
  • Monthly Discharge