Wednesday, December 14, 2011

Dirty Hands in the Gloves

Just because latex gloves are worn during clinical care does not mean that the hands are clean. An article recently published in Infection Control and Hospital Epidemiology is revealing on this matter.

The observational study was performed in a large and likely representative sample of British hospitals. The investigators  observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Gloves were used in only 26% of the 7,578 moments for hand hygiene and in17% of 3,292 low-risk contacts; gloves were not used in 21% of 669 high-risk contacts. 

The rate of hand hygiene compliance with glove use was low 41% and the rate without glove use was 50.0%. After statistically adjustment, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]

Hand hygiene is low, gloves are not worn when indicated and glove use is associated with a decrease in hand hygiene.

We observed a similar hand hygiene reduction during a universal gloving study that we published several years ago.

We need a better understanding of what motivates healthcare workers to wash their hands before and after glove use. 

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