Have gloves and gowns had their day?: An Australian and New Zealand practice and attitudes survey about contact precautions for MRSA and VRE colonisation

Sarah Browning; Joshua S. Davis; Brett G. Mitchell

doi:10.1016/j.idh.2023.03.006

Have gloves and gowns had their day? An Australian and New Zealand practice and attitudes survey about contact precautions for MRSA and VRE colonisation

Sarah Browning, Joshua S. Davis, Brett G. Mitchell

Global and Tropical Health

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

61 Downloads (Pure)

Abstract

Background: ‘Contact precautions,’ are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that gowns and gloves are of no added benefit over hand hygiene and environmental cleaning, guidelines continue to recommend them.

Methods: A cross-sectional online survey of infection prevention professionals, infectious diseases physicians and microbiologists in Australian and New Zealand hospitals was conducted. The purpose was to explore variations in current approaches to known MRSA and VRE colonisation, and determine clinical equipoise for a proposed randomised control trial (RCT) to withdraw the use of gowns and gloves in this setting.

Results: 226 responses from 122 hospitals across all Australian jurisdiction and multiple regions of New Zealand were received. While most hospitals implement contact precautions for MRSA (86%) and VRE (92%), variations based on MRSA and VRE subtypes are common. There was strong interest in removing glove and gown use for MRSA (72% and 73%, respectively) and VRE (70% and 68%, respectively). 62% of surveyed hospitals expressed interest in participating in a proposed cluster RCT comparing discontinuation of gown and glove use as part of contact precautions for MRSA and VRE, with their ongoing use.

Conclusion: The mandated use of PPE in the context of MRSA and VRE colonisation warrants further examination. An RCT is needed to definitively address this issue and to promote a widespread change in practice, if warranted.

Original language	English
Pages (from-to)	221-225
Number of pages	5
Journal	Infection, Disease and Health
Volume	28
Issue number	3
DOIs	https://doi.org/10.1016/j.idh.2023.03.006
Publication status	Published - Aug 2023

Bibliographical note

Funding Information:
There was no direct funding to support this project. The project was supported in-kind by the Infection program at the Hunter Medical Research Institute, Newcastle . BM is the recipient of a NHMRC Investigator grant ( GNT2008392 ).

Publisher Copyright:
© 2023 The Author(s)

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.idh.2023.03.006

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Cite this

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title = "Have gloves and gowns had their day?: An Australian and New Zealand practice and attitudes survey about contact precautions for MRSA and VRE colonisation",

abstract = "Background: {\textquoteleft}Contact precautions,{\textquoteright} are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that gowns and gloves are of no added benefit over hand hygiene and environmental cleaning, guidelines continue to recommend them. Methods: A cross-sectional online survey of infection prevention professionals, infectious diseases physicians and microbiologists in Australian and New Zealand hospitals was conducted. The purpose was to explore variations in current approaches to known MRSA and VRE colonisation, and determine clinical equipoise for a proposed randomised control trial (RCT) to withdraw the use of gowns and gloves in this setting. Results: 226 responses from 122 hospitals across all Australian jurisdiction and multiple regions of New Zealand were received. While most hospitals implement contact precautions for MRSA (86%) and VRE (92%), variations based on MRSA and VRE subtypes are common. There was strong interest in removing glove and gown use for MRSA (72% and 73%, respectively) and VRE (70% and 68%, respectively). 62% of surveyed hospitals expressed interest in participating in a proposed cluster RCT comparing discontinuation of gown and glove use as part of contact precautions for MRSA and VRE, with their ongoing use. Conclusion: The mandated use of PPE in the context of MRSA and VRE colonisation warrants further examination. An RCT is needed to definitively address this issue and to promote a widespread change in practice, if warranted.",

keywords = "Contact precautions, Methicillin-resistant Staphylococcus aureus, Multi-resistant organisms, Personal protective equipment, Vancomycin-resistant Enterococci",

author = "Sarah Browning and Davis, {Joshua S.} and Mitchell, {Brett G.}",

note = "Funding Information: There was no direct funding to support this project. The project was supported in-kind by the Infection program at the Hunter Medical Research Institute, Newcastle . BM is the recipient of a NHMRC Investigator grant ( GNT2008392 ). Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = aug,

doi = "10.1016/j.idh.2023.03.006",

language = "English",

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AU - Davis, Joshua S.

AU - Mitchell, Brett G.

N1 - Funding Information: There was no direct funding to support this project. The project was supported in-kind by the Infection program at the Hunter Medical Research Institute, Newcastle . BM is the recipient of a NHMRC Investigator grant ( GNT2008392 ). Publisher Copyright: © 2023 The Author(s)

PY - 2023/8

Y1 - 2023/8

N2 - Background: ‘Contact precautions,’ are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that gowns and gloves are of no added benefit over hand hygiene and environmental cleaning, guidelines continue to recommend them. Methods: A cross-sectional online survey of infection prevention professionals, infectious diseases physicians and microbiologists in Australian and New Zealand hospitals was conducted. The purpose was to explore variations in current approaches to known MRSA and VRE colonisation, and determine clinical equipoise for a proposed randomised control trial (RCT) to withdraw the use of gowns and gloves in this setting. Results: 226 responses from 122 hospitals across all Australian jurisdiction and multiple regions of New Zealand were received. While most hospitals implement contact precautions for MRSA (86%) and VRE (92%), variations based on MRSA and VRE subtypes are common. There was strong interest in removing glove and gown use for MRSA (72% and 73%, respectively) and VRE (70% and 68%, respectively). 62% of surveyed hospitals expressed interest in participating in a proposed cluster RCT comparing discontinuation of gown and glove use as part of contact precautions for MRSA and VRE, with their ongoing use. Conclusion: The mandated use of PPE in the context of MRSA and VRE colonisation warrants further examination. An RCT is needed to definitively address this issue and to promote a widespread change in practice, if warranted.

AB - Background: ‘Contact precautions,’ are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that gowns and gloves are of no added benefit over hand hygiene and environmental cleaning, guidelines continue to recommend them. Methods: A cross-sectional online survey of infection prevention professionals, infectious diseases physicians and microbiologists in Australian and New Zealand hospitals was conducted. The purpose was to explore variations in current approaches to known MRSA and VRE colonisation, and determine clinical equipoise for a proposed randomised control trial (RCT) to withdraw the use of gowns and gloves in this setting. Results: 226 responses from 122 hospitals across all Australian jurisdiction and multiple regions of New Zealand were received. While most hospitals implement contact precautions for MRSA (86%) and VRE (92%), variations based on MRSA and VRE subtypes are common. There was strong interest in removing glove and gown use for MRSA (72% and 73%, respectively) and VRE (70% and 68%, respectively). 62% of surveyed hospitals expressed interest in participating in a proposed cluster RCT comparing discontinuation of gown and glove use as part of contact precautions for MRSA and VRE, with their ongoing use. Conclusion: The mandated use of PPE in the context of MRSA and VRE colonisation warrants further examination. An RCT is needed to definitively address this issue and to promote a widespread change in practice, if warranted.

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