Gloves Are No Substitute for Proper Hand Hygiene

Richard T. Ellison III, MD

Journal Watch 

Abstract and Introduction

Abstract

Healthcare workers frequently neglect hand hygiene when they use gloves.

Introduction

Although the use of latex gloves by healthcare workers (HCWs) can protect against transmission of pathogens, gloves are subject to perforation, and contamination can occur when the gloves are donned or removed. Consequently, WHO guidelines recommend that gloves be changed between patients and that hands be cleaned both before putting on gloves and after removing them. Investigators recently assessed compliance with these guidelines in 56 wards in 15 hospitals in the U.K. that were participating in a larger national study on HCWs' hand hygiene.
Overall, gloves were used in 26% of 7578 HCW hand-hygiene "moments." They were worn in 17% of low-risk contacts (when they would not have been clinically indicated) but were not worn in 25% of high-risk contacts (when they would have been indicated). The rates of hand-hygiene compliance before and after patient contact were 30% and 47%, respectively, when gloves were worn — significantly lower than those observed when gloves were not worn (40% and 52%).

Comment

This study highlights an apparent lack of knowledge among HCWs regarding the need for hand cleaning before and after glove use. Education should be intensified in this area.

References

• Fuller C et al. "The dirty hand in the latex glove": A study of hand hygiene compliance when gloves are worn. Infect Control Hosp Epidemiol 2011 Dec; 32:1194.

 

Journal Watch © 2011 Massachusetts Medical Society