We describe an investigation and improvement project designed to provide comfortable, affordable, fluid-resistant isolation gowns in response to inadequate compliance with gown use.
These methods of infection control — hand washing, alcohol foams, physical isolation, gowns, gloves and sometimes masks and eye protection — are now a routine part of clinical life in hospitals across the country; up to a quarter of all hospitalized patients at any time are placed under such restrictions.
Two employees worked together to take isolation gowns on and off and to aid and supervise each other.
In the three participating hospitals, MRSA or C. difficile were recovered from unused (clean) linen and/or isolation gowns.
Therefore, it may be necessary to clean and disinfect storage carts to prevent cross-contamination in addition to conducting an audit of the laundry process to ensure that linen and isolation gowns are not contaminated prior to use.
Given the recognized major role of the environment in transmission, contact precautions are recommended through segregating CDI from non-CDI patients; limiting patient movement through the healthcare facility; vigilant equipment disinfection; and wearing isolation gowns and gloves for each patient encounter.
A similar study in a VRE-endemic oncology unit found that enhanced precautions, which included surveillance cultures, hand-washing, and contact isolation with gown and glove use, resulted in fewer VRE bloodstream infections and colonized patients, with a net saving of US$189,318 over 1 year [ 32].
The total cost of active surveillance cultures was US$91,108, and the cost of contact isolation - including gown, gloves and labor - was US$1.18 per patient per visit.
Hospital policy already specified that all patients with VRE required contact isolation including a gown and gloves for anyone entering the room.
Colleges around the country have abandoned a fortress-like, town-gown isolation and are finding a variety of ways, from anthropological and sociological study to outright redevelopment, of building bridges to their host communities.
