Preventing the Spread of Infection in Nursing Homes

Nursing homes are settings with a high rate of Staphylococcus aureus (SA) acquisition, which
leads to infection, particularly for short stay residents. The current standard of care for
preventing SA acquisition and SA infection in nursing homes is Standard Precautions (gowns
and gloves for anticipated contact with blood, body fluids, skin breakdown or mucous
membranes) for all residents.

The investigators propose a feasibility study of a novel strategy, the addition of targeted
gown and glove use, to prevent SA acquisition and SA infection in residents of nursing homes.
Rather than wearing gowns and gloves for all care activities to prevent transmission, gown
and glove use can be targeted to specific high risk "moments" of care for specific high risk
residents. High risk "moments" for gown and glove use are care activities most likely to
transmit SA based on prior research. Residents with chronic wounds and medical devices are:
1) most likely to be colonized with SA; 2) most likely to acquire SA; 3) most likely to
transmit SA to healthcare worker clothing and hands; and 4) most likely to develop a SA
infection based on prior research and thus would be considered high risk residents.

The investigators will perform a quasi-experimental (before-after) study of this
intervention, targeted gown and glove use, at two community-based nursing homes to
demonstrate its feasibility and evaluate its effect on SA acquisition and SA infection rates.

Inclusion Criteria:

- Age ≥18 years

- Reside in a participating nursing home

Exclusion Criteria:

- Identified by nursing home staff as combative or with other behavioral problems which
could lead to agitation if approached by project staff