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

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 [1]Medical Environment Update [1].

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:

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