Gown and Glove Use to Prevent the Spread of Infection in VA Community Living Centers

Completed

• Conditions: Methicillin-Resistant Staphylococcus Aureus

• Registration Number: NCT01350479
• Lead Sponsor: VA Office of Research and Development

Brief Summary

Methicillin-resistant S. aureus (MRSA) infections are a common cause of morbidity and mortality in nursing home residents. MRSA is predominantly spread from patient-to-patient by health care workers. The use of gowns, gloves and hand washing prevents this spread; however, their use detracts from a patient-centered, home-like environment which is an important priority for nursing homes. The goal of this project is to determine when it is most important for health care workers to wear gowns and to wash their hands when caring for MRSA colonized Veterans in community living centers.

Detailed Description

Methicillin-resistant S. aureus (MRSA) infections are a common cause of morbidity and mortality in nursing home residents. MRSA is predominantly spread from patient-to-patient by health care workers. The use of gowns, gloves and hand washing prevents this spread; however, their use detracts from a patient-centered, home-like environment which is an important priority for nursing homes. The goal of this project is to determine when it is most important for health care workers to wear gowns and to wash their hands when caring for MRSA colonized Veterans in community living centers. To meet this goal, the investigators will enroll \~400 MRSA-colonized residents and health care workers from VA community living centers in four states and the District of Columbia. Additionally, the investigators will enroll some non-MRSA colonized residents as control subjects. Each enrolled resident will be followed for 6-25 episodes of care observations over 30 days. During each observation, the investigators will have health care workers wear disposable gowns and gloves during each care activity (e.g. wound dressing) that occurs during the study visit. At the end of each care activity, the investigators will swab the gown and gloves prior to disposing of them. Each swab will be tested for MRSA to determine if MRSA from the resident was transferred to the healthcare worker's gown or gloves during that episode of care. The results of the investigators' analysis will be used to develop new infection control guidelines which balance patient safety and a home-like, patient-centered environment.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2011-05-06
• Study First Submitted QC: 2011-05-06
• Study First Posted: 2011-05-09
• Study Start: 2012-10-01
• Primary Completion: 2016-01-15
• Study Completion: 2016-11-01
• Results First Submitted: 2016-11-16
• Results First Submitted QC: 2017-01-24
• Results First Posted: 2017-03-15
• Status Verified: 2017-09
• Last Update Submitted: 2017-09-06
• Last Update Posted: 2017-10-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 203

Inclusion Criteria

Resident:

• Age 18 years
• Reside in a participating LTCF for rehabilitation, skilled nursing or maintenance care
• Expected length of stay of >4 weeks from enrollment
• Written informed consent from participant, or written informed consent from legally authorized representative (LAR) with assent from participant

Health Care Worker:

• Has direct interaction with participating residents at participating VA Long Term Care Facility (LTCF)
• Verbal informed consent

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Exclusion Criteria

Residents:

• None

Health Care Worker:

• Unable or unwilling to wear protective gown or gloves during healthcare workers (HCW)-resident interaction

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
MRSA Transmission	Will be measured during 6-25 episodes of care interactions scheduled over the 30 days following resident enrollment	Presence of MRSA on gown or gloves worn by enrolled health care worker for research purposes while providing a specific type of care for enrolled resident

Trial Locations

Locations (7)

Washington DC VA Medical Center, Washington, DC; 🇺🇸 Washington, D.C., District of Columbia, United States

Perry Point VA Medical Center VA Maryland Health Care System, Perry Point, MD; 🇺🇸 Perry Point, Maryland, United States

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD; 🇺🇸 Baltimore, Maryland, United States

Rehabilitation R&D Service, Baltimore, MD; 🇺🇸 Baltimore, Maryland, United States

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA; 🇺🇸 Boston, Massachusetts, United States

VA Western New York Healthcare System, Buffalo, NY; 🇺🇸 Buffalo, New York, United States

South Texas Health Care System, San Antonio, TX; 🇺🇸 San Antonio, Texas, United States