| Methods |
The purpose of this study was to evaluate whether the use of a disposable plastic goggle designed to cover the eyes and nose could help reduce the rate of nosocomial infections during an outbreak of RSV infection. The rates of RSV infection in staff members and infants were determined on an infant and toddler ward during a seven‐week study. Two 3‐week study periods were compared: period 1, during which all staff members used the goggles, and period 2, were no goggles were worn. The respiratory infection control procedures were the same during both periods of study: handwashing, isolation and cohorting. In reality although on report, Gala and colleagues are conducting 2 studies. The first is a non‐concurrent cohort study, in which 2 different population of children are assessed separated by a 1‐week 'wash‐out' period and the intervention (goggles) on staff. The play of confounders here is too heavy and uncontrolled to include the data in the study. The second is a controlled before and after on the 40‐odd members of staff (32 of whom took part in both periods). Here the play of confounders should be partly reduced. We extracted data relating to the second study only |
| Participants |
74 children and 40 staff members in period 1; 77 children and 41 staff members in period 2. During the study 151 children were admitted to the ward; their mean age was 12.9 months, 59% were boys. During period 174 infants were examined, 15 were admitted with RSV infections, the remaining 59 constituted the group potentially susceptible to a nosocomial RSV infection. Seventeen infants were hospitalised for sufficient time for a nosocomial infection and in 1 nosocomial RSV infection was detected. During period 277 babies were studied, 17 of whom were admitted with RSV infection. Of the remaining 60, 39 children were excluded, 21 were considered susceptible, and in 9 of them nosocomial RSV infection was detected. Forty staff members were examined in period 1 and 41 during period 2. During period 2, 2 of the ward staff acquired RSV infection and were not considered susceptible |
| Interventions |
Use of a disposable plastic eye‐nose goggle and respiratory infection control procedures versus only respiratory infection control procedures (cohorting, isolation and handwashing) |
| Outcomes |
Laboratory: serological evidence
Effectiveness: RSV infection (symptoms and laboratory confirmation)
Safety: n/a |
| Notes |
Risk of bias: high
Notes: the use of the disposable eye‐nose goggles appeared to be associated with a significant decrease in nosocomial RSV infections (6% versus 42% of contacts when the goggles were used compared to when they were not). The expense of such goggles will have to be determined and compared with the cost of nosocomial infections. The study has an orgy of confounders, is it difficult to see how such studies can be carried out without disrupting patient care? Why not randomise staff to goggles or standard care? |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
N/A |
| Allocation concealment (selection bias) |
Unclear risk |
N/A |
| Blinding (performance bias and detection bias)
All outcomes |
Unclear risk |
N/A |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
N/A |
| Selective reporting (reporting bias) |
Unclear risk |
N/A |
