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Sepsis NewbornGloveCareNCT03078335

Glove-based Care in the NICU to Prevent Late Onset Sepsis

A study testing Glove based care in people with Sepsis Newborn and Infection, run by Hamilton Health Sciences Corporation at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Babies that get an infection after 3 days of age while in the Neonatal Intensive Care Unit is not related to their delivery but to the hospital environment. Preventing these infections results in shorter hospital stays for babies, less risk of long term health problems and less health care resources required to care… Read more about this study

Who is it for?
Ages 1 minute and olderHealthy volunteers can take part
Conditions the study is for
Sepsis Newborn, Infection
What is being tested?
Glove based care
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
786 participants
Where
1 siteCanada
Study dates
5 Jun 2017to 1 Jun 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 minute and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Infants admitted to the NICU at participating sites for > 2 days until discharge

Who cannot join

  • Babies requiring contact precautions due to other reasons (as glove based care would be occurring)

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • McMaster Children's Hospital

    Hamilton, Ontario, L8N3Z5

Other trials in Canada

About this study

Official title: Non-Sterile Glove Based Care to Prevent Late Onset Sepsis in The NICU - Cluster Crossover Randomized Controlled Pilot Study

Babies that get an infection after 3 days of age while in the Neonatal Intensive Care Unit is not related to their delivery but to the hospital environment. Preventing these infections results in shorter hospital stays for babies, less risk of long term health problems and less health care resources required to care for them. Hand washing alone doesn't remove all bacteria from the hands of healthcare workers, and studies have shown that infections in adults and children admitted to hospital decrease if health care providers use clean, non- sterile gloves when treating patients. The main focus of this study will be to find out if using gloves when caring for newborns in the NICU is better than washing hands alone. McMaster Children's Hospital and The Hospital for Sick Children will be the pilot sites to participate in a future larger study where some infants will be cared for using non-sterile gloves, and others will be cared for using the standard hand washing method.

Read the detailed description

Late onset sepsis (LOS) is defined as infection occurring after 72 hours of life in neonates admitted to the Neonatal Intensive Care Unit (NICU). LOS can lead to severe complications including death, major neurologic sequelae, and contribute to increased length of stay and costs of care. These hospital acquired infections are largely preventable. Hand washing prior to any patient care is considered the cornerstone of prevention and is the standard of care in the NICU. Adherence to hand washing however is difficult to achieve, with estimates of compliance among health care workers ranging from 30% to 60%. Observational studies in at-risk critically ill children suggest a reduction in hospital acquired infections and central line associated bloodstream infections with glove based care in addition to hand hygiene. One small single-centre randomized trial of glove based care versus hand hygiene alone to assess LOS rates in extremely premature infants in the NICU showed a reduction in gram positive infections and central line infections with glove-based care. We propose to test the effect of glove based care in an adequately powered, rigorously designed and conducted, cluster randomized controlled trial (RCT) after completing a feasibility pilot study.

This pilot study will include all babies in the NICU being randomized to 6 months of glove based care or standard of care, and then the following 6 months will be the opposite arm. All health care provider contact with the infant will require gloves in the intervention arm, but families of infants admitted to the NICU will not be required to wear gloves. The main outcome measured will be the number of episodes of infections in the blood, urinary tract, and cerebrospinal fluid comparing the glove intervention arm against the control arm. Invasive infections are an important challenge for infants admitted to the NICU and reducing this risk can improve the quality and quantity of neonatal survivors from the NICU.

Being tested
Glove based care, Standard of Care - Hand Hygiene
Keywords
Late onset sepsis, glove based care, NICU, Non sterile gloves, infection control
Medical subject headings
Neonatal Sepsis, Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Glove based careOther

    Described in Experimental Arm: Glove based care

  • Standard of Care - Hand HygieneOther

    Hand Hygiene - hand washing with soap and water, or alcohol based hand rub

Study groups in NCT03078335
Study groupRoleWhat they receive
Glove based careExperimentalThe intervention is the use of non-sterile gloves, after standard hand hygiene for all routine patient care needs.
Receives: Other: Glove based care
Standard careActive comparatorThe control group will provide standard care, that is, hand hygiene before all patient, bed, and intravenous catheter contact.
Receives: Other: Standard of Care - Hand Hygiene

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Late onset sepsis events

    The anticipated incidence of LOS is 10% of patients based on Canadian Neonatal Network retrospective data. Infection is defined as blood stream, urinary tract, or cerebrospinal fluid infection based on 1 or more positive cultures with a bacterial or fungal pathogen (2 cultures required for Coagulase negative staphylococcus), at least 2 compatible signs and symptoms (including temperature instability, hemodynamic changes, respiratory distress and increased inflammatory markers), and the need for antimicrobial treatment.

    Measured: Weeks of admission to the NICU. Infection must occur at >72 hours of age, throughout neonatal admissions for the 6 month duration of each study arm

Secondary outcomes (4)
  1. Time to first infection

    Time from admission to NICU to first infection in days

    Measured: Time from admission to NICU to discharge (days to months) throughout neonatal admissions for the 6 month duration of each study arm]

  2. Length of stay

    Time from admission to discharge (days)

    Measured: Time from admission to discharge (days to months) throughout neonatal admissions for the 6 month duration of each study arm]

  3. All-cause mortality

    Number of deaths (number of patients who die during study)

    Measured: Duration of study (1 year)

  4. Proportion colonized by antibiotic resistant organisms at any point during their NICU stay

    Proportion of infants who become colonized with antibiotic resistant organisms during surveillance screening as part of routine care (number of patients)

    Measured: Weeks of admission to NICU, for the duration of study (1 year)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Mar 2017
  2. Study start5 Jun 2017
  3. Primary completion1 Jun 2018
  4. Study completion1 Jun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Crossover
Model description
This pilot study is a single centre NICU based cluster-randomized crossover trial, with 2 crossover periods each lasting 6 months, and a 2-week washout period in between.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
786 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03078335
Sponsor's protocol ID
GloveCare
Acronym
GloveCare
Status last verified
Aug 2018
First submitted
1 Feb 2017
Last updated
9 Aug 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, Laptook AR, Sanchez PJ, Van Meurs KP, Wyckoff M, Das A, Hale EC, Ball MB, Newman NS, Schibler K, Poindexter BB, Kennedy KA, Cotten CM, Watterberg KL, D'Angio CT, DeMauro SB, Truog WE, Devaskar U, Higgins RD; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA. 2015 Sep 8;314(10):1039-51. doi: 10.1001/jama.2015.10244.

    PubMed 26348753
  • Orcesi S, Olivieri I, Longo S, Perotti G, La Piana R, Tinelli C, Spinillo A, Balottin U, Stronati M. Neurodevelopmental outcome of preterm very low birth weight infants born from 2005 to 2007. Eur J Paediatr Neurol. 2012 Nov;16(6):716-23. doi: 10.1016/j.ejpn.2012.05.006. Epub 2012 Jun 17.

    PubMed 22709626
  • Alemagno SA, Guten SM, Warthman S, Young E, Mackay DS. Online learning to improve hand hygiene knowledge and compliance among health care workers. J Contin Educ Nurs. 2010 Oct;41(10):463-71. doi: 10.3928/00220124-20100610-06. Epub 2010 Jun 8.

    PubMed 20540459
  • Yin J, Schweizer ML, Herwaldt LA, Pottinger JM, Perencevich EN. Benefits of universal gloving on hospital-acquired infections in acute care pediatric units. Pediatrics. 2013 May;131(5):e1515-20. doi: 10.1542/peds.2012-3389. Epub 2013 Apr 22.

    PubMed 23610206
  • Johnson S, Gerding DN, Olson MM, Weiler MD, Hughes RA, Clabots CR, Peterson LR. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med. 1990 Feb;88(2):137-40. doi: 10.1016/0002-9343(90)90462-m.

    PubMed 2301439
  • Kaufman DA, Blackman A, Conaway MR, Sinkin RA. Nonsterile glove use in addition to hand hygiene to prevent late-onset infection in preterm infants: randomized clinical trial. JAMA Pediatr. 2014 Oct;168(10):909-16. doi: 10.1001/jamapediatrics.2014.953.

    PubMed 25111196
  • Edwards WH, Conner JM, Soll RF; Vermont Oxford Network Neonatal Skin Care Study Group. The effect of prophylactic ointment therapy on nosocomial sepsis rates and skin integrity in infants with birth weights of 501 to 1000 g. Pediatrics. 2004 May;113(5):1195-203. doi: 10.1542/peds.113.5.1195.

    PubMed 15121929
  • Shah J, Jefferies AL, Yoon EW, Lee SK, Shah PS; Canadian Neonatal Network. Risk Factors and Outcomes of Late-Onset Bacterial Sepsis in Preterm Neonates Born at < 32 Weeks' Gestation. Am J Perinatol. 2015 Jun;32(7):675-82. doi: 10.1055/s-0034-1393936. Epub 2014 Dec 8.

    PubMed 25486288
  • Tsai MH, Hsu JF, Chu SM, Lien R, Huang HR, Chiang MC, Fu RH, Lee CW, Huang YC. Incidence, clinical characteristics and risk factors for adverse outcome in neonates with late-onset sepsis. Pediatr Infect Dis J. 2014 Jan;33(1):e7-e13. doi: 10.1097/INF.0b013e3182a72ee0.

    PubMed 23899966
  • Samuelsson A, Isaksson B, Hanberger H, Olhager E. Late-onset neonatal sepsis, risk factors and interventions: an analysis of recurrent outbreaks of Serratia marcescens, 2006-2011. J Hosp Infect. 2014 Jan;86(1):57-63. doi: 10.1016/j.jhin.2013.09.017. Epub 2013 Oct 23.

    PubMed 24332914
  • Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed. 2015 May;100(3):F257-63. doi: 10.1136/archdischild-2014-306213. Epub 2014 Nov 25.

    PubMed 25425653
  • Wong JL, Siti Azrin AH, Narizan MI, Norliah Y, Noraida M, Amanina A, Nabilah I, Habsah H, Siti Asma H. Back to basic: bio-burden on hands of health care personnel in tertiary teaching hospital in Malaysia. Trop Biomed. 2014 Sep;31(3):534-9.

    PubMed 25382481
  • Sharma VS, Dutta S, Taneja N, Narang A. Comparing hand hygiene measures in a neonatal ICU: a randomized crossover trial. Indian Pediatr. 2013 Oct;50(10):917-21. doi: 10.1007/s13312-013-0261-3. Epub 2013 Mar 5.

    PubMed 23585422
  • Monistrol O, Lopez ML, Riera M, Font R, Nicolas C, Escobar MA, Freixas N, Garau J, Calbo E. Hand contamination during routine care in medical wards: the role of hand hygiene compliance. J Med Microbiol. 2013 Apr;62(Pt 4):623-629. doi: 10.1099/jmm.0.050328-0. Epub 2013 Jan 17.

    PubMed 23329322
  • Moolenaar RL, Crutcher JM, San Joaquin VH, Sewell LV, Hutwagner LC, Carson LA, Robison DA, Smithee LM, Jarvis WR. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol. 2000 Feb;21(2):80-5. doi: 10.1086/501739.

    PubMed 10697282

Questions about this trial

What is this clinical trial studying?

A study testing Glove based care in people with Sepsis Newborn and Infection, run by Hamilton Health Sciences Corporation at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Late onset sepsis events (time frame: Weeks of admission to the NICU. Infection must occur at >72 hours of age, throughout neonatal admissions for the 6 month duration of each study arm). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03078335, which also lists 21 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Aug 2018.

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