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Overgown Use for Infection Control in Nurseries and Neonatal Intensive Care Units

Overgown Use for Infection Control in Nurseries and Neonatal Intensive Care Units Abstract • We surveyed 1824 physicians to determine (1) current newborn nursery (NBN) and neonatal intensive care unit (NICU) gowning procedures and (2) the gowning preferences of NBN and NICU physicians. A total of 712 questionnaires (39.0%) were returned from 453 hospitals. Of the 712 questionnaire respondents, 251 (35.3%) thought that gowns should be worn at all times. However, 319 (72.8%) of the 438 NBNs and 317 (71.6%) of the 443 NICUs surveyed continue to require gowns at all times. The difference between gown preference and practice was statistically significant. Gowns were worn only for handling infants in 96 NBNs (21.9%) and 109 NICUs (24.6%), while 344 physicians (48.3%) preferred this regimen. Gowns were worn in 16 NBNs (3.7%) and 15 NICUs (3.4%) only for isolated infants, but 67 respondents (9.4%) believed this to be the procedure of choice. At our institution, 100 and 300 gowns are worn daily in the NBN and NICU, respectively, at a cost of $0.28 per gown use, generating an estimated yearly expense of $40 880. In addition, the current literature does not support gowning as a means of infection control in this setting. (AJDC 1986;140:680-683) References 1. Forfar JO, MacCabe AF: Masking and gowning in nurseries for the newborn infant: Effect on staphylococcal carriage and infection . Br Med J 1958;1:76-79.Crossref 2. Gezon HM, Rogers KD, Thompson DJ, et al: II. Some controversial aspects in the epidemiology of hospital nursery staphylococcal infections . Am J Public Health 1960;50:473-484.Crossref 3. Williams CPS, Oliver TK: Nursery routines and staphylococcal colonization of the newborn . Pediatrics 1969;44:640-646. 4. Renaud MT: Effects of discontinuing cover gowns on a postpartal ward upon cord colonization of the newborn . J Obstet Gynecol Neonatal Nursing 1983;12:399-401.Crossref 5. Silverman WA, Sinclair JC: Evaluation of precautions before entering a neonatal unit . Pediatrics 1967;40:900-901. 6. Agbayani M, Rosenfeld W, Evans H, et al: Evaluation of modified gowning procedures in a neonatal intensive care unit . AJDC 1981;135: 650-652. 7. Evans HE, Akpata SO, Baki A: Bacteriologic and clinical evaluation of gowning in a premature nursery . J Pediatr 1971;78:883-886.Crossref 8. Control of infections in obstetric and nursery areas , in Brann AW Jr, Cefalo RC (eds): Guidelines for Perinatal Care . Evanston, Ill, American Academy of Pediatrics/The American College of Obstetricians and Gynecologists (Washington, DC), 1983, p 114. 9. Garner JS, Simmons BP: CDC guideline for isolation precautions in hospitals . Infect Control 1983;4:254. 10. Mortimer EA, Lipsitz PJ, Wolinsky E, et al: Transmission of staphylococci between newborns: Importance of the hands of personnel . AJDC 1962;104:289-295. 11. Donowitz LG: Efficacy of the overgown in preventing nosocomial infection in a pediatric intensive care unit . Pediatrics 1986;77:35-38. 12. Basler DS, Sheridan JF, Bajo K: 1982 Guide to Centers Providing Perinatal and Neonatal Special Care . Columbus, Ohio, Ross Laboratories, 1982. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Overgown Use for Infection Control in Nurseries and Neonatal Intensive Care Units

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1986.02140210078030
Publisher site
See Article on Publisher Site

Abstract

Abstract • We surveyed 1824 physicians to determine (1) current newborn nursery (NBN) and neonatal intensive care unit (NICU) gowning procedures and (2) the gowning preferences of NBN and NICU physicians. A total of 712 questionnaires (39.0%) were returned from 453 hospitals. Of the 712 questionnaire respondents, 251 (35.3%) thought that gowns should be worn at all times. However, 319 (72.8%) of the 438 NBNs and 317 (71.6%) of the 443 NICUs surveyed continue to require gowns at all times. The difference between gown preference and practice was statistically significant. Gowns were worn only for handling infants in 96 NBNs (21.9%) and 109 NICUs (24.6%), while 344 physicians (48.3%) preferred this regimen. Gowns were worn in 16 NBNs (3.7%) and 15 NICUs (3.4%) only for isolated infants, but 67 respondents (9.4%) believed this to be the procedure of choice. At our institution, 100 and 300 gowns are worn daily in the NBN and NICU, respectively, at a cost of $0.28 per gown use, generating an estimated yearly expense of $40 880. In addition, the current literature does not support gowning as a means of infection control in this setting. (AJDC 1986;140:680-683) References 1. Forfar JO, MacCabe AF: Masking and gowning in nurseries for the newborn infant: Effect on staphylococcal carriage and infection . Br Med J 1958;1:76-79.Crossref 2. Gezon HM, Rogers KD, Thompson DJ, et al: II. Some controversial aspects in the epidemiology of hospital nursery staphylococcal infections . Am J Public Health 1960;50:473-484.Crossref 3. Williams CPS, Oliver TK: Nursery routines and staphylococcal colonization of the newborn . Pediatrics 1969;44:640-646. 4. Renaud MT: Effects of discontinuing cover gowns on a postpartal ward upon cord colonization of the newborn . J Obstet Gynecol Neonatal Nursing 1983;12:399-401.Crossref 5. Silverman WA, Sinclair JC: Evaluation of precautions before entering a neonatal unit . Pediatrics 1967;40:900-901. 6. Agbayani M, Rosenfeld W, Evans H, et al: Evaluation of modified gowning procedures in a neonatal intensive care unit . AJDC 1981;135: 650-652. 7. Evans HE, Akpata SO, Baki A: Bacteriologic and clinical evaluation of gowning in a premature nursery . J Pediatr 1971;78:883-886.Crossref 8. Control of infections in obstetric and nursery areas , in Brann AW Jr, Cefalo RC (eds): Guidelines for Perinatal Care . Evanston, Ill, American Academy of Pediatrics/The American College of Obstetricians and Gynecologists (Washington, DC), 1983, p 114. 9. Garner JS, Simmons BP: CDC guideline for isolation precautions in hospitals . Infect Control 1983;4:254. 10. Mortimer EA, Lipsitz PJ, Wolinsky E, et al: Transmission of staphylococci between newborns: Importance of the hands of personnel . AJDC 1962;104:289-295. 11. Donowitz LG: Efficacy of the overgown in preventing nosocomial infection in a pediatric intensive care unit . Pediatrics 1986;77:35-38. 12. Basler DS, Sheridan JF, Bajo K: 1982 Guide to Centers Providing Perinatal and Neonatal Special Care . Columbus, Ohio, Ross Laboratories, 1982.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1986

References