title: The Effect of Universal Glove and Gown Use on Adverse Events in Intensive Care Unit Patients.
abstract: BACKGROUND
  No randomized trials have examined the effect of contact precautions or universal glove and gown use on adverse events. We assessed if wearing gloves and gowns during all patient contact in the intensive care unit (ICU) changes adverse event rates.
  
  
  METHODS
  From January 2012 to October 2012, intervention ICUs of the 20-site Benefits of Universal Gloving and Gowning cluster randomized trial required that healthcare workers use gloves and gowns for all patient contact. We randomly sampled 1800 medical records of adult patients not colonized with antibiotic-resistant bacteria and reviewed them for adverse events using the Institute for Healthcare Improvement Global Trigger Tool.
  
  
  RESULTS
  Four hundred forty-seven patients (24.8%) had 1 or more ICU adverse events. Adverse events were not associated with universal glove and gown use (incidence rate ratio [IRR], 0.81; 95% confidence interval [CI], .48-1.36). This did not change with adjustment for ICU type, severity of illness, academic hospital status, and ICU size, (IRR, 0.91; 95% CI, .59-1.42; P = .68). Rates of infectious adverse events also did not differ after adjusting for the same factors (IRR, 0.75; 95% CI, .47-1.21; P = .24).
  
  
  CONCLUSIONS
  In ICUs where healthcare workers donned gloves and gowns for all patient contact, patients were no more likely to experience adverse events than in control ICUs. Concerns of adverse events resulting from universal glove and gown use were not supported. Similar considerations may be appropriate regarding use of contact precautions.
  
  
  BACKGROUND
  NCT0131821.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Croft
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine VA Maryland Healthcare System.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harris
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: Lisa
authors.initials: L
authors.lastname: Pineles
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: Michelle
authors.initials: M
authors.lastname: Shardell
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine VA Maryland Healthcare System Department of Medicine, Division of General Internal Medicine, University of Maryland School of Medicine.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Fink
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore.
authors.forename: Linda
authors.initials: L
authors.lastname: Simoni-Wastila
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine VA Maryland Healthcare System.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006302:Health Services Research; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: adverse events; contact precautions; patient harm; universal glove and gown