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Gloves are a potential barrier to hand hygiene, especially amongst nurses
Rather than improving hygiene, glove use in healthcare settings can actually create a potential barrier to hand hygiene - especially amongst nurses, reports Healio this week.
The World Health Organisation says that while hand hygiene and the use of examination gloves in healthcare is critical, healthcare personnel should perform hand hygiene procedures, either using alcohol-based hand-rub or soap and water, both before and after donning gloves, and that gloves should only be worn in certain scenarios. A recent study has found, however, that the use of gloves can create 'a missed opportunity' when it comes to hygiene.
The study, led by Richard A. Martinello, MD, associate professor of medicine and pediatrics at the Yale School of Medicine and medical director of infection prevention at Yale New Haven Hospital and Yale New Haven Health, was published in 'Infection Control & Hospital Epidemiology'. It says:
"Evidence has suggested that inappropriate use of examination gloves was a significant cause of missed [hand hygiene] opportunities at our and other institutions."
To investigate glove use as a potential barrier to hand hygiene, Richard Martinello and colleagues conducted a prospective quantitative and qualitative study in adult and pediatric medical-surgical wards and ICUs over the last four months of 2016. This involved a 'secret shopper' scenario where the wash-in and wash-out procedures by healthcare professionals providing hands-on inpatient care were recorded, along with instances where gloves were worn in lieu of hand hygiene.
The observer noted that compliance with hand hygiene was 74.5% for both wash-in and wash-out opportunities. The highest percentage of hand hygiene opportunities (41%) were performed by registered nurses, followed by, (at 16%) licensed independent practitioners such as physicians, physician assistants and advanced practice registered nurses and nursing assistants.
The study showed that 45% of wash-in episodes lacking compliance with hand hygiene protocol were performed by registered nurses, and that 44% of all wash-in episodes lacking such compliance were performed by staff who wore gloves. These episodes were observed more frequently among registered nurses (47%), according to the researchers.
Interviews performed during the study identified four major drivers of glove use: protection and safety of staff and patients, the availability of gloves, previous medical training guidance and barriers to hand hygiene. Other lesser mentioned barriers included workload, distance to washbasins and the growing use of hospital-supported mobile phones. The researchers noted that it may be useful to re-educate healthcare professionals about proper glove use and hand hygiene.
"Overall, compliance was high among healt care professionals," they concluded. "Gloves were found to be a potential barrier to hand hygiene and use in lieu of hand hygiene was greatest among nursing staff. Glove use was shown to be driven by staff desire for personal safety and potentially learned during professional training."
29th November 2018