1. A controlled trial was conducted in the medical ICU of an 820-bed, tertiary care, academic medical center. Phase 1 (P1) was a 3-month period of standard practice in which patients were placed in contact precautions per CDC guidelines. In the second 3 months, phase 2 (P2), gloves were required for all patient contact and no patients were placed in contact precautions. Hand hygiene and infection control (IC) compliance observations were performed by trained observers. An anonymous,14 item questionnaire was administered to MICU nurses and attending physicians at study completion. The survey focused on self reported compliance with infection control practices and the acceptability of universal gloving vs. standard of care. Healthcare Worker Attitudes During A Controlled Trial of Universal Gloving for Preventing the Transmission of Multidrug-Resistant Pathogens Gonzalo M.L. Bearman MD, MPH, Alexandre Marra MD, Curt Sessler MD, Wally Smith MD, Richard P. Wenzel MD,MSc, Michael B. Edmond, MD, MPH, MPA Virginia Commonwealth University School of Medicine, Richmond, VA Background: Contact precautions are recommended to reduce the transmission of multidrug (MDR)- resistant pathogens. However, healthcare worker attitude towards universal gloving as the standard of care is unknown. Purpose: We studied healthcare worker attitudes during a universal gloving study for preventing the transmission of MDR pathogens. Method: A controlled trial was conducted in our medical ICU. Phase 1(P1) was a 3-month period of standard practice in which patients were placed in contact precautions per CDC guidelines. In the second 3 months, phase 2 (P2), gloves were required for all patient contact and no patients were placed in contact precautions. Hand hygiene and infection control (IC) compliance observation was performed by trained observers. An anonymous,14 item questionnaire was administered to MICU nurses and attending physicians at study end. The focus was self reported compliance with infection control practice and acceptability of universal gloving vs.standard of care. Results: There were 34 respondents with an overall survey compliance of 65%. Of the respondents, 30 were nurses (45 eligible) and 4 were attending physicians (7 eligible). Twelve percent of respondents indicated that universal gloving was impractical. Ninety-seven percent of respondents reported good compliance with infection control measures and with hand hygiene. Forty-eight percent of HCWs reported less frequent entry into a patient room because of contact precautions while few (6%) believed that proper glove use is more important than hand hygiene to limit the spread of nosocomial organisms. Ninety-four percent believed that the use of gloves was associated with decreased risk of cross- transmission of nosocomial organisms and 93% of HCWs reported no difference in skin problems (e.g., chapping, dryness, cracking) when comparing contact precautions to universal gloving. The majority of the respondents (52%) felt that better care was delivered during the universal gloving phase of the study. Hand hygiene compliance was 58% in P1 vs. 52% in P2 (P=0.01). Compliance with infection control practices (contact precautions in P1 vs. universal gloving in P2) was 76% vs. 87% (P<0.001). Conclusion: During a controlled trial, compliance with universal gloving was significantly greater than compliance with contact precautions. However, greater compliance with hand hygiene was observed in the contact precautions phase. HCWs found universal gloving acceptable, believed that it was associated with a decreased risk of cross-transmission of nosocomial organisms, and believed that overall better care was delivered with universal gloving than with contact precautions. ABSTRACTMETHODS RESULTS CONCLUSIONSOBJECTIVES To assess HCW self reported compliance with infection control practices during the course of a universal gloving study protocol To assess HCW acceptability of universal gloving vs. standard of care Questionnaire Item:Proportion Proportion of respondents indicating that universal glove use was impractical 12% Proportion of respondents reporting good compliance with infection control measures 97% Proportion of respondents reporting good compliance with hand hygiene 97% HCWs reporting less frequent entry into a patient room because of contact precautions 48% Questionnaire Item:Proportion Belief that proper glove use is more important than hand hygiene to limit the spread of nosocomial organisms 6% Belief that the use of gloves is associated with decreased risk of cross-transmission of nosocomial organisms 94% HCWs reporting no difference in skin problems (e.g., chapping, dryness, cracking) 93% Overall better care is delivered when: HCWs found universal gloving an acceptable alternative to contact precautions HCWs believed that universal gloving results in a decreased risk of transmission of nosocomial organisms HCWs believed that overall better care was delivered during the universal gloving phase of the study HCWs overestimate their compliance with infection control measures There were 34 respondents with an overall survey compliance of 65%. 30 were nurses (45 eligible) 4 were attending physicians (7 eligible) 13% 53% 34% Abstract # 231 Presentation # : 147