Hand Hygiene Australia - Glove Use Policy

Glove Use Policy

The impact of wearing gloves on adherance to hand hygiene policies has not been definitively established since published studies have yielded contradictory results ⁽¹⁾.

Several studies found that HCWs who wore gloves were less likely to cleanse their hands upon leaving a patient's room. In contrast, other studies found that HCWs who wore gloves were significantly more likely to cleanse their hands following patient care. Another study found that the introduction of gloves increased the overall compliance with hand hygiene, but the introduction of isolation precautions did not result in a better compliance with hand hygiene.

Evidence for the Use of Gloves

This summary of evidence is from The WHO Guidelines on Hand Hygiene in Health Care May 2009.

The use of gloves does not replace the need for hand hygiene by either handrubbing or handwashing (1B)

Wear gloves when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, or non-intact skin will occur (1C).

Remove gloves after caring for a patient. Do not wear the same pair of gloves for the care of more than one patient (1B)

When wearing gloves, change or remove gloves during patient care if moving from a contaminated body site to either another body site (including non-intact skin, mucous membrane or medical device) within the same patient or the environment (II)..

The reuse of gloves is not recommended (IB).

Glove Use

Disposable gloves are recommended to be worn for two main reasons ⁽¹⁾:

To reduce the risk of contamination of HCWs hands with blood and other body fluids
To reduce the risk of spreading germs to the environment and transmission from the HCW to the patient and vice versa, as well as from one patient to another

The efficacy of gloves in preventing contamination of HCWs hands and helping to reduce transmission of pathogens in healthcare has been confirmed in several clinical studies ⁽¹⁾. However, HCWs should be informed that gloves do not provide complete protection against hand contamination. Pathogens may gain access to the HCWs hands via small defects in gloves or by contamination of the hands during glove removal. Bacterial flora colonising patients may be recovered from the hands of < 30% of HCWs who wear gloves during patient contact ⁽³⁾.

The recommendation to wear gloves during an entire episode of care for a patient who requires contact precautions, without considering indications for their removal, such as for hand hygiene, could lead to the transmission of germs. Hayden and colleagues found that HCWs seldom enter patient rooms without touching the environment, and that 52% of HCWs whose hands were free of VRE upon entering rooms contaminated their hands or gloves with VRE after touching the environment without touching the patient ⁽⁶⁰⁾ .

Hand hygiene is required with glove use when:

An indication for hand hygiene precedes a contact that also requires glove usage, hand hygiene should be performed before donning gloves
An indication for hand hygiene follows a contact that has required gloves, hand hygiene should occur after removing gloves
An indication for hand hygiene applies while the HCW is wearing gloves, then gloves should be removed to perform hand hygiene