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1199. Provider Perspectives on Nonsterile Glove Use in the NICU

BACKGROUND: Late-onset infection is a serious cause of mortality and long-term morbidity in NICU patients. Healthcare worker hands are the most common vehicle for transmission of pathogenic organisms to neonates. Studies have suggested a reduction in infections in neonatal and pediatric patients car...

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Autores principales: Khan, Sarah, Science, Michelle, Arnold, Callum, Hawes, Judith, Lee, Kyong-soon, el Helou, Salhab, Sanchez, Pablo J, Mertz, Dominik, Kaufman, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808659/
http://dx.doi.org/10.1093/ofid/ofz360.1062
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author Khan, Sarah
Science, Michelle
Arnold, Callum
Hawes, Judith
Lee, Kyong-soon
el Helou, Salhab
Sanchez, Pablo J
Mertz, Dominik
Kaufman, David
author_facet Khan, Sarah
Science, Michelle
Arnold, Callum
Hawes, Judith
Lee, Kyong-soon
el Helou, Salhab
Sanchez, Pablo J
Mertz, Dominik
Kaufman, David
author_sort Khan, Sarah
collection PubMed
description BACKGROUND: Late-onset infection is a serious cause of mortality and long-term morbidity in NICU patients. Healthcare worker hands are the most common vehicle for transmission of pathogenic organisms to neonates. Studies have suggested a reduction in infections in neonatal and pediatric patients cared for with universal nonsterile glove use. METHODS: We developed an online survey (https://fhspeds.mcmaster.ca/pedsCapOne/surveys/?s=9RDX7EHT79) for clinicians to understand the current glove use and hand hygiene practices in NICUs in North America. The survey was sent to neonatologists and Pediatric Infectious Disease Specialists via the AAP Neonatal-Perinatal Section listserv, SHEA and the Canadian Neonatal Network. RESULTS: Of 336 responses; the majority were from physicians at level 3 to 4 NICUs (97%), and from the United States (96.1%). Beyond sterile procedures, sterile gloves were used for central line dressing changes (88.4%), contact with central nervous system shunts (61.0%), and direct contact with central lines (57.4%). Nonsterile gloves were used most commonly for universal precautions and diaper changes (Table 1). Almost half of participants also used nonsterile gloves for all patients and 37.5% for extremely low birth weight (<1000 g) infants. While most sites (76.8%) stated that nonsterile gloves were not required for parents, 15.8% requested gloves also for parents. 58% of respondents felt there was not enough evidence for a practice change at this time and 53.3% felt further study was needed to assess the effect of nonsterile gloves and infection (Figures 2 and 3). Almost a third of respondents (n = 109) would be interested in participating in a randomized study to assess glove-based care. Major concerns with this approach included a possible reduction in hand hygiene compliance, environmental waste, and glove contamination (Figure 4). CONCLUSION: There is variability in gloving practices across NICUs in North America, with equipoise and interest in a potential randomized study to further explore the hypothesis that nonsterile gloves prevent late-onset infections in neonates. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68086592019-10-28 1199. Provider Perspectives on Nonsterile Glove Use in the NICU Khan, Sarah Science, Michelle Arnold, Callum Hawes, Judith Lee, Kyong-soon el Helou, Salhab Sanchez, Pablo J Mertz, Dominik Kaufman, David Open Forum Infect Dis Abstracts BACKGROUND: Late-onset infection is a serious cause of mortality and long-term morbidity in NICU patients. Healthcare worker hands are the most common vehicle for transmission of pathogenic organisms to neonates. Studies have suggested a reduction in infections in neonatal and pediatric patients cared for with universal nonsterile glove use. METHODS: We developed an online survey (https://fhspeds.mcmaster.ca/pedsCapOne/surveys/?s=9RDX7EHT79) for clinicians to understand the current glove use and hand hygiene practices in NICUs in North America. The survey was sent to neonatologists and Pediatric Infectious Disease Specialists via the AAP Neonatal-Perinatal Section listserv, SHEA and the Canadian Neonatal Network. RESULTS: Of 336 responses; the majority were from physicians at level 3 to 4 NICUs (97%), and from the United States (96.1%). Beyond sterile procedures, sterile gloves were used for central line dressing changes (88.4%), contact with central nervous system shunts (61.0%), and direct contact with central lines (57.4%). Nonsterile gloves were used most commonly for universal precautions and diaper changes (Table 1). Almost half of participants also used nonsterile gloves for all patients and 37.5% for extremely low birth weight (<1000 g) infants. While most sites (76.8%) stated that nonsterile gloves were not required for parents, 15.8% requested gloves also for parents. 58% of respondents felt there was not enough evidence for a practice change at this time and 53.3% felt further study was needed to assess the effect of nonsterile gloves and infection (Figures 2 and 3). Almost a third of respondents (n = 109) would be interested in participating in a randomized study to assess glove-based care. Major concerns with this approach included a possible reduction in hand hygiene compliance, environmental waste, and glove contamination (Figure 4). CONCLUSION: There is variability in gloving practices across NICUs in North America, with equipoise and interest in a potential randomized study to further explore the hypothesis that nonsterile gloves prevent late-onset infections in neonates. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6808659/ http://dx.doi.org/10.1093/ofid/ofz360.1062 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Khan, Sarah
Science, Michelle
Arnold, Callum
Hawes, Judith
Lee, Kyong-soon
el Helou, Salhab
Sanchez, Pablo J
Mertz, Dominik
Kaufman, David
1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title 1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title_full 1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title_fullStr 1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title_full_unstemmed 1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title_short 1199. Provider Perspectives on Nonsterile Glove Use in the NICU
title_sort 1199. provider perspectives on nonsterile glove use in the nicu
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808659/
http://dx.doi.org/10.1093/ofid/ofz360.1062
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