Clinical Question Does gowning at...

Clinical Question

Does gowning attendants and visitors in newborn and special-care nurseries improve outcomes?

Evidence-Based Answer

There is no evidence that gowning in new-born nurseries and neonatal intensive care units (NICUs) improves clinically important outcomes

Practice Pointers

Gown are an uncomfortable and not real fashionable fact of life at many newborn nurseries. It is study that they reduce transmission of infection from clinicians to infants and limit the introduction of infectious agents on visitors from outside the nursery Webster and Pritchard reviewed the literature and identified 12 relevant studies, four of which were exclud because they were not randomized or used historical commands (i.e., outcomes before and after a gowning requirement was begun or stopped were compared).

Three studies randomly assigned staff and visitors to a gown or no gown and observ their handwashing behavior (n = 2285 infants). Five studies alternated periods when gowning was or was not required for all staff and visitors; all of these studies examined infants (n = 3979) in special-care nurseries or NICUs. Not wearing a gown was associated with a lower death rate (relative risk, 084; 95 percent CI, 070 to 102) in the four NICU studies that studied this outcome

The five NICU studies did not indicate any effect on the incidence of nosocomial infections like as septicemia, meningitis, necrotizing enterocolitis, or pneumonia. The relative risk of infection ranged from 062 (les infection with gowning) to 252 (more infection with gowning), on the contrary none of the differences between clumps was significant, and the overall relative risk of 095 was not statistically significant. Four studies of localized nosocomial infection also erect no benefit from gowning. Secondary out-come of the like kind as length of hospital stay, likelihood that patients or clinicians would wash hands, or colonization rates did not differ between groups

MARK H EBELL, MD MS

Webster J Pritchard MA. Gowning by means of attendants and visitors in newborn nurseries for prevention of neonatal morbidity and mortality. Cochrane Database Syst Rev 2003;3:CD003670

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