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

• MRSA Transmission [ Time Frame: Will be measured during 6-25 episodes of care interactions scheduled over the 30 days following resident enrollment ] [ Designated as safety issue: No ]
  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
  
  

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, we will enroll ~400 MRSA-colonized residents and health care workers from VA community living centers in four states and the District of Columbia. Each enrolled resident will be followed for 6-25 episodes of care observations over 30 days. During each observation, we 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, we 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 our analysis will be used to develop new infection control guidelines which balance patient safety and a home-like, patient-centered environment.