PEDIATRICS Vol. 77 No. 1 January 1986, pp. 35-38
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Failure of the Overgown to Prevent Nosocomial Infection in a Pediatric Intensive Care Unit

Leigh G. Donowitz MD1

1 From the Department of Pediatrics, University of Virginia School of Medicine, Charlottesville

In a pediatric intensive care unit we conducted a 1-year prospective study of 454 patients to determine whether wearing a gown decreased the overall nosocomial infection rate, incidence of intravascular catheter colonization, breaks in handwashing technique, and traffic.

The overall infection rate was 26 (13%) of 198 admissions during the gown-wearing periods v 23 (9%) of 256 admissions for the periods when gowns were not worn (P < .25). Of 348 intravascular catheter tips cultured 16 (4.6%) were colonized during gown-wearing periods compared with 21 (6.3%) of 330 when no gowns were worn (P < .25). Of 78 patient contacts 54 (69%) were followed by no handwashing during gown-wearing periods and 59 (70%) of 84 contacts were followed by no handwashing during periods when no gowns were worn. The mean occurrence of visits per patient per hour and total visits per hour differed between gown-wearing and no-gown-wearing periods by analysis of variance, P < .01 and P < .005, respectively. Although traffic was decreased during periods of gown use, overgowns are an expensive, ineffective method of decreasing nosocomial infection rates, vascular catheter colonization rates, and breaks in handwashing technique.

Key Words: overgown • nosocomial infection • intensive care unit

Submitted on April 22, 1985
Accepted on June 7, 1985