Healthcare workers who wear gloves while treating patients are less likely to clean their hands before and after patient contact, according to a study. This failure of basic hand hygiene could be contributing to the spread of infection in healthcare settings, the researchers said.
Glove use is appropriate for situations when contact with body fluids is anticipated or when patients are to be managed with contact precautions. However, the researchers said, use of gloves should not be considered a substitute for effective hand hygiene practices taking place before and after patient contact. Although gloves can reduce the number of germs transmitted to the hands, germs can sometimes still get through latex. Hands can also be contaminated by “back spray” when gloves are removed after contact with body fluids.
British researchers, led by Sheldon Stone, MD, of the Royal Free Hospital NHS Trust, observed more than 7,000 patient contacts in 56 ICUs and geriatric care units in 15 hospitals in the United Kingdom, making this one of the largest and most detailed studies on gloves and their impact on hand hygiene.
Overall, the study found that hand hygiene compliance was “disappointingly low” at just 47.7%. Compliance was even lower in instances where gloves were worn, dipping to just over 41%.
“The chances of hands being cleaned before or after patient contact appear to be substantially lower if gloves were being worn,” Stone said. “We call this the phenomenon of the ‘Dirty Hand in the Latex Glove.'”
The results also revealed an opportunity to reduce healthcare-associated infections by focusing further hand hygiene improvement efforts on better hand hygiene when using gloves. Doing so may prove the critical step in getting overall hand hygiene to the levels needed to prevent transmission of infection, the researchers said.
Stone and his colleagues suggested further study on the behavioral reasons behind why healthcare workers are less likely to wash their hands when wearing gloves. Regardless, the researchers recommended that campaigns such as the World Health Organization’s Clean Care is Safer Care program should emphasize better hand hygiene associated with gloving practices.
The study — “The Dirty Hand in the Latex Glove: A Study of Hand-Hygiene Compliance When Gloves Are Worn” — will appear in the December issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.