Evaluation of Modified Gowning Procedures in a Neonatal Intensive Care Unit

The effect of modified gowning techniques in a neonatal intensive care unit was evaluated. During alternate two-month intervals, no gowns were worn over street clothes in patient care areas by staff or visitors. Mortality and infection rates during these “modified” gowning intervals were the same as during the gowning periods. However, the incidence of necrotizing enterocolitis was significantly greater in the modified gowning period (7/353) than in the gowning periods (1/371). An expansion of this one-year study to include another year showed an even greater effect. The prevalence of bacteria at three anatomic sites (nares, umbilicus, and groin) on days 2, 4, 7, 10, 14, 21, and 28 of hospitalization was comparable between those studied during modified gowning and gowning intervals. Exceptions were the significantly increased prevalence of Staphylococcus epidermidis in the groin (days 21 and 28) during gowning and S aureus in the nares (day 28) during modified gowning periods. (Am J Dis Child 1981;135:650-652) Environmental controls are routinely used in neonatal intensive care units (NICUs) to decrease the likelihood of superficial or systemic infections in high-risk cases. However, certain controls may limit the frequency of medical and family visits, add to expense, and are not of proven value in the control of infection. We previously demonstrated¹ no adverse effect on mortality, infection rate, or prevalence of bacterial flora related to a "no gowning" procedure in neonates cared for in incubators (Isolettes) or open cribs. However, gowns were always worn when the incubator’s hood was open. The present study.