Inappropriate glove use often undermines efforts to sustain correct hand hygiene according to the 5 Moments for Hand Hygiene.
Gloves can protect both patients and HCWs from exposure to infectious agents that may be carried on hands (66). As part of standard precautions gloves must be worn as a single-use item for (68):
- Each invasive procedure
- Contact with sterile sites and non-intact skin or mucous membranes
- Any activity that has been assessed as carrying a risk of exposure to blood, body substances, secretions and excretions.
However, 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 approximately 30% of HCWs who wear gloves during patient contact (3, 67, 69).
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 HH, 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 products and gloves should be made available inside isolation/contact precaution rooms to allow for appropriate hand hygiene to occur during the care of a patient.
Wearing gloves does not replace the need for hand hygiene.
When should gloves be changed?
Gloves should be changed:
- Between episodes of care for different patients, to prevent transmission of infectious material (70-71)
- During the care of each patient, to prevent cross-contamination of body sites (3)
- If the patient interaction involves touching portable computer keyboards or other mobile equipment that is transported from room to room (71)
Sterile gloves must be used for surgical ANTT procedures and contact with sterile sites (68). Single use gloves should always be discarded.
Hand hygiene is required with glove use at the following times:
- Before putting on gloves
- Immediately after removing gloves
- Gloves should be removed to perform HH during the care for a single patient as indicated by the 5 Moments for Hand Hygiene
- Hand hygiene products should not be applied to gloves
Prolonged and indiscriminate use of gloves should be avoided as it may cause adverse reactions and skin sensitivity (70).
For further information on glove use refer to the Australian Guidelines for the Prevention and Control of Infection in Healthcare (68).