Kicking a dirty habit: Hand hygiene rates lower when gloves are used—Medical Environment Update, March 2012

By: March 14th, 2012 Email This Post Print This Post

Most healthcare facilities have created some sort of campaign to raise levels of hand hygiene compliance—from creating signs and uploading sing-along viral videos to deploying “secret shoppers” around the nation to sneakily observe who is or isn’t washing their hands.

Yet a new study shows that when it comes to one specific practice—cleaning hands before and after glove use—healthcare workers have much lower rates of compliance, and that is is the focus of the March issue of Medical Environment Update.

Here is an excerpt.

According to generally accepted guidelines, such as those issued by the CDC, gloves should be used when contact with body fluids is anticipated or when patients are to be managed with contact precautions. However, although gloves can reduce the number of germs transmitted to the hands, they do not provide total protection; some germs can get through the latex.

Gloves provide false sense of protection

Sheldon Stone, MD, a physician at the Royal Free Hospital NHS Trust in London, has observed more than 7,000 patient contacts in 56 intensive care and acute care elderly wards in 15 U.K. hospitals. His study is one of the largest and most detailed on gloves and their impact on hand hygiene.

The study was published in the December 2011 issue of Infection Control and Hospital Epidemiology. According to the study, the overall hand hygiene compliance rate across all observed patient contacts was only 47.7%, but when gloves were used, compliance dropped even lower, to 41%.

“We were stunned, really, that somebody should embark on a dirty procedure with gloves and then not clean their hands afterwards,” says Stone. “It was just unbelievable.”

Stone suspects that patients likely assume workers practice proper hand hygiene, but his study shows this may not be the case.

“If you’re a patient and your healthcare worker has a clinical contact with you, what we found is that the relative probability of someone wearing gloves, of cleaning their hands before or after coming in contact with you, is about a third less than if they do not have gloves at all,” says Stone.

His discovery of low rates of hand hygiene with glove use may provide a new way for workplace safety, infection control (IC), and patient safety professionals to focus their attention on the topic. After all, the point of hand hygiene is not 100% compliance with hand hygiene policy; it’s to lower or eliminate infection spread by healthcare workers.

So how can healthcare facilities increase hand hygiene when gloves are used?

Also appearing in March issue of Medical Environment Update:

  • Vital stats: How confident are you that staff members are performing hand hygiene before and after using gloves?
  • WHO recommendations on the use of gloves
  • Study: Nurses risk lost pregnancies
  • Flu mask misuse and decontamination
  • Safety officer tip: Play it safe with the general duty clause
  • Self-inspection notes: Identifying workplace violence potential
  • Q&A on carpeting in lab blood draw rooms; storing medications and specimens in the same refrigerator; eyewash station maintenance for bloodborne exposures
  • A true/false quiz designed to test your understanding of OSHA standards and government regulatory guidelines that apply to healthcare facilities. (Download from the Tools page.)
  • Updates to your OSHA Program Manual on March on healthcare jobs subject to the Bloodborne Pathogens standard; PPE declination investigation form; revised list of common OSHA standards for medical and dental practices

For information subscribing to Medical Environment Update, click on the links below.

Get into compliance with HCPro’s Basic OSHA Compliance Manual Kits for medical or dental practices. Receive bimonthly electronic manual updates through your newsletter subscription that keep your regulatory manual up to date and in compliance!


By Susan Murley on March 14th, 2012 at 10:28 am

I read that when gloves are worn, normal flora, bacteria and other germs proliferate in the warm, moist environment under the gloves, especially if hands are not washed prior to putting on gloves. That helped me visualize and understand the extreme importance of washing hands prior and after glove use. I share this when I teach staff and find it helpful for those that need to know “Why.”


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