Gloves are an essential part of personal protective equipment (PPE) used in standard precautions. The use of gloves serves the same purpose as hand hygiene: to prevent the transmission of microorganisms from the hands of health care workers to patients, as well as patients to health workers. However, many staff do not realise that the protection provided by the gloves is incomplete. In one study it was found that during routine work with patients contamination of the hands of workers who did not use gloves was 16 bacteria per minute, but for those staff wearing gloves it was still 3 bacteria per minute. Therefore, the use of gloves does NOT remove the need for  hand hygiene after their use. 


Hand should be clean before doning gloves and hands MUST to be cleaned again immediately after their removal. The method of hand hygiene before doning gloves is determined by the procedure that will be implemented in patients (procedure within standard precautions or invasive procedure). The method of hand hygiene after removing gloves depends on whether the gloves during the procedure were torn or hands are visibly dirty (hand washing), or whether gloves are not torn and hands are not visibly soiled (hand rubbing). If whilst performing a procedure wearing gloves there arises an  indication  for hand hygiene  (for example, switching from a contaminated to a clean part of the body), those gloves MUST be removed and hand hygiene performed before doning a new set of gloves.

The correct use of gloves is an essential, but often ignored, aspect of  hand hygiene compliance. Their incorrect use by definition is an example of reduced hand hygiene compliance. Audits of hand hygiene should also consider these aspects but often do not.

Their misuse should be considered a serious breach of duty of patient care as it can lead  to  increased spread of microorganisms.

_____

Link to IC/HH Core competencies: Area 4 Infection control activities: Domain Elaborating infection control intervention ICA 1-2

References:

  1. WHO Guidelines on Hand Hygiene in Health Care. World Health Organization 2009 WHO/IER/PSP/2009.07 http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf
  2. Pittet D et al. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Int Med 1999;159:821-6.
  3. Bearman GM, Marra AR, Sessler MN et al. A control trial of universal gloving versus contact precautions for preventing the transmission of multidrug-resistant organisms. Am J Infect Control 2007;35:650-5.
  4. Fuller C, Savage J, Besser S, Hayward A,  Cookson B,  Cooper B, Stone S. The Dirty Hand in the Latex Glove: A Study of Hand-Hygiene Compliance When Gloves Are Worn.” Infect Cont Hosp Epidemiol 2011;32:1194-99.
  5. Borg MA, Benbachir M, Cookson BD,   Ben Redjeb S,  Elnasser Z,  Rasslan O,  Gu¨r D,  Daoud Z,  Pieridou Bagatzouni D.  Self-protection as a driver for hand hygiene among healthcare workers. Infect Control Hosp Epidemiol 2009; 30:578-580.