Hailey Tran
The use of gowns in hospitals is a critical component of infection prevention and control activities. Gowns are a form of personal protective equipment (PPE) that helps to protect healthcare workers and patients from the spread of infectious diseases, such as Hepatitis B, Hepatitis C, HIV, SARS, and avian flu. While the specific guidelines for gown usage may vary based on national or organizational recommendations, the general principle is to wear a gown when anticipating direct contact with patients, potentially contaminated surfaces, or bodily fluids. This includes both healthcare workers and visitors, such as family members, who come into close contact with patients or their immediate environment. The proper use of gowns, along with other PPE, is essential to minimize the risk of infection transmission and protect the health and safety of everyone involved.
| Characteristics | Values |
|---|---|
| When to wear a gown | When anticipating direct contact with the patient or potentially contaminated surfaces or equipment in close proximity to the patient |
| When to don a gown | Upon entry into the room or cubicle |
| When to remove a gown | Before leaving the patient-care environment |
| Who should wear a gown | Doctors, nurses, healthcare workers, parents, family, and guests |
| When family members don't need to wear a gown | When resting on bedside furniture, during kangaroo care (skin-to-skin care), or while breastfeeding |
| When family members do need to wear a gown | When helping with the child's care or coming in contact with body fluids, e.g. when helping with dressing changes, suctioning, or holding a child with diarrhea or vomiting on their lap |
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What You'll Learn
- Gowns are required when in direct contact with patients or contaminated surfaces/equipment
- Gowns are not necessary when resting bedside, but mandatory when helping with care
- Parents must wear gowns when holding a child with diarrhoea or vomiting
- Gowns are not required during skin-to-skin care, but hand hygiene is essential
- Gloves must be worn on both hands, with clean and dry hands underneath
Gowns are required when in direct contact with patients or contaminated surfaces/equipment
In a healthcare setting, it is essential to adhere to strict infection control protocols to prevent the spread of diseases and ensure patient and staff safety. Gowns are a critical component of personal protective equipment (PPE) and act as a protective barrier against potential contamination.
The CDC's Healthcare Infection Control Practice Advisory Committee (HICPAC) provides guidelines for contact precautions, recommending the use of gowns when direct contact with patients or contaminated surfaces/equipment is anticipated. This recommendation is echoed by the Joint Commission, emphasizing the importance of donning a gown upon entering a patient's room and removing it before exiting, along with practicing hand hygiene.
Healthcare workers, such as nurses' aides, who are likely to come into close contact with patients or contaminated areas, are expected to wear gowns. For instance, when performing a bed bath for a patient, the aide would be expected to wear a gown to prevent the spread of healthcare-associated infections. On the other hand, a group of residents performing rounds with an attending physician may pose a lower risk of clothing contamination and, therefore, might not require gowns.
The type and extent of protective clothing required depend on the specific situation and the anticipated degree of exposure. In some cases, additional protective gear such as surgical caps, hoods, shoe covers, gloves, laboratory coats, face shields, masks, and eye protection may be necessary to ensure a comprehensive barrier against contamination.
It is crucial to follow established protocols for donning and removing PPE, including gowns, to ensure maximum effectiveness in preventing the spread of infections. Proper disposal and decontamination procedures are also essential to maintain a safe environment for patients and healthcare workers alike.
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Gowns are not necessary when resting bedside, but mandatory when helping with care
Hospitals implement various infection prevention and control activities to limit the spread of infections and protect patients, visitors, and healthcare workers. Federal law requires hospitals to follow Standard Precautions and Transmission-Based Precautions (Isolation) to achieve this.
Standard Precautions refer to good handwashing practices before entering and after leaving a patient's room. Healthcare workers may also use gloves, gowns, masks, eye protection, or face shields when providing patient care.
Transmission-Based Precautions (Isolation) are additional measures taken when the spread of infection cannot be effectively prevented by Standard Precautions alone. This includes the use of personal protective equipment (PPE) to minimise the spread of pathogenic microbes. PPE may include gowns, gloves, eye protection, face shields, masks, respirators, and head and shoe coverings.
The need for and type of gown selected as PPE is based on the anticipated degree of contact with infectious material and the potential for blood and body fluid penetration of the barrier. Gowns are recommended when there is direct contact with the patient or potentially contaminated surfaces or equipment in close proximity to the patient.
In the context of family members visiting a child in the hospital, gowns are not necessary when parents are simply resting bedside. However, gowns become mandatory when parents or family members are actively helping with the child's care or coming into contact with body fluids. For example, if parents are assisting with dressing changes, suctioning, or holding a child who has diarrhoea or has been vomiting, a gown and gloves are required. This is to prevent the spread of certain germs that can be transmitted through contact with skin or body fluids, as well as contaminated surfaces in the patient's room.
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Parents must wear gowns when holding a child with diarrhoea or vomiting
Diarrhoea and vomiting in children are usually caused by a viral infection of the stomach or mild food poisoning. The main risk associated with these symptoms is dehydration, which can be identified by decreased urine output, dark-coloured urine, a dry mouth, and dizziness when standing. As such, it is important to ensure that the child stays hydrated.
In addition to the risk of dehydration, diarrhoea and vomiting can also indicate an infectious disease. Indeed, vomiting and diarrhoea can be highly contagious, and schools often request that children with these symptoms stay at home to prevent the spread of infection. Therefore, it is crucial for parents to wear gowns when holding a child with diarrhoea or vomiting to protect themselves from potential infection and to prevent the spread of infection to others.
Guidelines from the CDC's Healthcare Infection Control Practice Advisory Committee (HICPAC) recommend wearing a gown when anticipating direct or indirect contact with contaminated surfaces or equipment in close proximity to the patient. While these guidelines are primarily intended for healthcare settings, they can also be applied to school health staff, such as school nurses. By wearing gowns and other personal protective equipment (PPE), caregivers can minimise their exposure to infectious materials and help prevent the spread of infectious diseases.
In a hospital setting, the Joint Commission, a healthcare accreditation organisation, also emphasises the importance of wearing gowns to prevent the spread of healthcare-associated infections. They recommend that healthcare workers don a gown upon entering a patient's room if they anticipate direct contact with the patient or contaminated surfaces. This recommendation is based on the high morbidity and mortality rates associated with healthcare-associated infections. Therefore, parents should adhere to gowning protocols when holding a child with diarrhoea or vomiting in a hospital setting to protect themselves and others from potential infection.
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Gowns are not required during skin-to-skin care, but hand hygiene is essential
Gowns are not necessary for family members engaging in skin-to-skin care with their loved ones in the hospital. However, proper hand hygiene is of utmost importance in this situation. Hand hygiene is a general term referring to any action of hand cleansing, including the use of alcohol-based hand rubs and washing with soap and water.
Hand hygiene is crucial as it significantly reduces the presence of microorganisms on hands, contributing to the prevention of healthcare-associated infections and enhancing patient safety. The World Health Organization's "5 Moments for Hand Hygiene" approach emphasizes the critical times for hand hygiene to minimize the risk of microorganism transmission between healthcare workers, patients, and the environment. These moments include immediately before touching the patient, before a procedure, and after removing gloves or after a procedure involving body fluid exposure risk.
For skin-to-skin care specifically, family members should perform hand hygiene before and after such intimate interactions. This practice ensures that any microorganisms on their hands, including their own, do not come into contact with the patient, reducing the risk of infection.
Additionally, it is essential to be mindful of the potential for skin irritation due to frequent hand hygiene, especially with the use of soaps, detergents, and paper towels. Strategies to minimize this include using hand hygiene products containing skin emollients, moisturizing hands regularly, and educating staff and family members on proper hand hygiene practices and hand care.
Overall, while gowns may not be required for skin-to-skin care in hospitals, maintaining fastidious hand hygiene practices is vital to ensure the safety of patients and prevent the spread of microorganisms.
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Gloves must be worn on both hands, with clean and dry hands underneath
Wearing gloves is essential for specific activities, such as disinfecting with cleaning chemicals or caring for someone who is unwell. In these situations, it is recommended to wear gloves to prevent the spread of germs and protect yourself and others. Gloves act as a protective barrier, ensuring that any bacteria, viruses, or contaminants are not transferred from one surface to another or from one person to another.
In a healthcare setting, such as a hospital, gloves are a crucial component of infection control and prevention measures. Healthcare workers, such as nurses and doctors, routinely wear gloves when examining patients, performing medical procedures, or handling medical equipment to prevent the spread of infections and maintain a sterile environment.
When it comes to family members visiting patients in hospitals, the use of gloves as a precaution may vary depending on the hospital's guidelines and the specific situation. In general, it is not necessary for family members to wear gloves during a routine visit if they are not directly caring for the patient or coming into contact with bodily fluids. However, if a patient has an infectious disease or is immunocompromised, the hospital may recommend that visitors take additional precautions, which could include wearing gloves.
Gloves must be worn on both hands, and it is essential to ensure that your hands are clean and dry before donning them. Hand hygiene is a critical aspect of infection control, and it involves more than just wearing gloves. Proper hand hygiene includes washing hands with soap and water or using an alcohol-based hand sanitiser before putting on gloves and after removing them. This helps prevent the spread of microorganisms, including bacteria and viruses, which can be harboured under fingernails, on jewellery, and on the skin. By maintaining clean and dry hands underneath gloves, you minimise the risk of transferring contaminants and reduce the likelihood of infection.
Additionally, it is important to remember that gloves should not be worn continuously throughout the entire hospital visit. Gloves should be changed frequently, especially when moving between different tasks or surfaces. This helps prevent cross-contamination and reduces the risk of spreading germs. After removing gloves, it is crucial to perform hand hygiene again to ensure that your hands remain clean and free of any potential contaminants.
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Frequently asked questions
Family members are not required to wear gowns when simply visiting their child in the hospital. However, gowns must be worn by parents when they are taking care of their child, such as when helping with dressing changes or suctioning.
Yes, everyone (including family members) must wash their hands with soap and water or use a waterless alcohol-based hand rub when entering and leaving the room.
Similar to visiting a child, family members are not required to wear gowns when simply visiting. However, gowns should be worn if the family member will be coming into direct contact with the patient or the patient's bodily fluids.
As with visiting a child, hand hygiene is crucial when visiting an adult patient in the hospital. Everyone must wash their hands with soap and water or use an alcohol-based hand rub when entering and leaving the room. Additionally, it is important to follow any posted precautions, such as Transmission-Based Precautions (Isolation) or Droplet Precautions, which may include wearing personal protective equipment (PPE) such as gowns, gloves, masks, or eye protection.
