| Methods |
Prospective cohort study conducted in 4 medical wards of the Royal Hospital for Sick Children in Glasgow, UK, to evaluate the effectiveness of 4 infection control procedures in preventing nosocomial infection with RSV. This is an interruption of transmission study. Every child up to 2, irrespective of clinical presentation, had respiratory secretions tested for RSV antigen within 18 hours of admission. Nosocomial infection was assumed if a child become RSV positive 7 days or more after admission. Children after discharge from hospital were not studied |
| Participants |
No special precaution group 152 (winter 1); gowns/gloves 337 (winter 1 and 2); cohort nursing 265 (winter 1 and 2); cohort nursing and gowns/gloves 310 (winter 1 and 2); 1001 (winter 3) |
| Interventions |
Stepwise intervention programmes: gowns/gloves; cohort nursing + gowns/gloves; cohort nursing, versus no special precautions. The procedures evaluated in the 2 winter periods were gowns/gloves; cohort nursing + gowns/gloves; cohort nursing, versus no special precautions. In the third year the most effective strategy was introduced into all ward areas and its efficacy in clinical practice was assessed. There was not separate area for managing children with infections |
| Outcomes |
Laboratory: yes ‐ culture, antibodies titres, serological studies
Effectiveness: RSV infections (seroconversion within 7 days of admission)
Safety: N/A |
| Notes |
Risk of bias: low
Notes: the authors conclude that combined with rapid laboratory diagnosis, cohort nursing and the wearing of gowns and gloves for all contacts with RSV‐infected children can significantly reduce the risk of nosocomial RSV infection (odds reduced to between 1.27% to 75.6%). One confounding effect that was not accounted for in the study design was a possible "ward effect". For practical reasons, 2 wards (3 and 4) continued with the same policy over the first 2 years of the study. Since it was also necessary apply policies to whole wards there is a possibility that ward 4 might have been especially effective at implementing their assigned policy |
| 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 |
