Each year, as many as 380,000 residents die of infections in long-term healthcare facilities, according to the Centers for Disease Control and Prevention. Hand hygiene, including the use of medical gloves, is imperative to preventing the spread of germs and protecting residents from illness. However, inappropriate use of gloves endangers both residents and those who care for them. To promote a safer environment, it is essential that skilled nursing care staff know when and how to properly use gloves. A few simple steps can help caregivers reduce the danger of spreading infection and protect residents from illness. Show
When to use glovesMultiple studies have proven that the use of medical gloves reduces the spread of germs in health care settings. However, gloves are not to be substituted for consistent hand hygiene practices. According to the World Health Organization (WHO), medical gloves should be used “during all patient-care activities that may involve exposure to blood and all other body fluid (including contact with mucous membrane and non-intact skin), during contact precautions and outbreak situations.” When contact with blood, body fluid, non-intact skin and mucous membrane ends, gloves need to be taken off, according to WHO. They should also be taken off when contact with a single resident, their surroundings and/or a contaminated body site ends. Finally, gloves should be taken off when they sustain damage or when hand hygiene needs be performed. Germs can also be spread when gloves are not changed at appropriate times. In a study written about by the Association for Professionals in Infection Control and Epidemiology, it was found that failure to change gloves was common among long-term healthcare certified nursing assistants (CNAs). According to the article, “CNAs must change gloves as a standard precaution at the following glove change points during patient care: when the gloves have touched blood or body fluids; after the CNA completes a patient task; after the gloves touch a potentially contaminated site; and in between patients.” Contaminated gloved touches significantly increase the potential for cross-contamination between residents and their environment. How to wear glovesBefore putting on gloves, hands should be thoroughly washed with soap and water or an alcohol-based hand sanitizer. For ease of putting on gloves, the hands should be completely dry. No oil-based hand creams or lotions should be used unless they are approved for use with latex gloves. Rings and wrist jewelry should be removed. Nursing staff need to wear the appropriate size glove that allows them to comfortably perform all resident care activities. When putting on the glove, the outside should be touched as little as possible. WHO recommends grabbing gloves by the top edge of the cuff to pull them on the hands without touching the skin of the forearm. Non-latex gloves should be worn if the resident or the staff member providing care is allergic to latex. Staff can also endanger themselves and others by not properly taking off their gloves. To take off gloves, the following procedure is recommended:
Consistent hand hygiene coupled with appropriate glove use protects residents and staff from infections. Facilities can help by continually educating staff on how to avoid poor habits, such as not changing gloves. Best practices along with ongoing vigilance will keep both residents and staff safer. Supply360 has quality medical gloves and infection control products at competitive prices. To learn more, click here. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. The incorrect use of clinical gloves and the failure to change them between procedures increases the risk of cross-transmission. Much attention has been focused on compliance with hand hygiene. AimTo investigate the use of gloves, their potential for cross-contamination, and factors that influence the decision of healthcare workers (HCWs) to wear them. MethodsThe use of gloves was observed in six wards in a single UK hospital trust. Risk of cross-contamination was defined as a violation of a ‘moment of hand hygiene’ during the glove-use episode. Twenty-five HCWs from the wards included in the observational audit were interviewed to identify the drivers for glove use. FindingsA total of 163 glove-use episodes were observed over a period of 13 h. Glove use was inappropriate in 69 out of 163 (42%) episodes, with gloves commonly used inappropriately for low-risk procedures (34/37; 92%). In 60 out of 163 (37%) episodes of glove use there was a risk of cross-contamination, most (48%) being associated with failure to remove gloves or with performing hand hygiene after use. HCW interviews indicated that the decision to wear gloves was influenced by both socialization and emotion. Key emotions were disgust and fear. Assumptions that patients preferred gloves to be used, confusion about when to wear them, and social norms and peer pressure were also important influences. ConclusionGlove use is associated with risk of cross-contamination and should be more explicitly integrated into hand hygiene policy. An understanding of the drivers of glove-use behaviour is required to design interventions to reduce misuse and overuse. IntroductionHealthcare-associated infections (HCAIs) are a considerable social and economic burden for patients, relatives and the health services, prolonging length of hospital stay, and increasing resistance to antimicrobial agents.1 They affect more than 6% of patients in hospitals in the UK, acutely ill patients being at four-fold greater risk.2 Hands are acknowledged to be a major vehicle of transmission of infection between patients and have been responsible for outbreaks of infection reported in the literature.1 Frequent hand hygiene during the delivery of healthcare is strongly recommended as the primary infection prevention measure, with the risk of transmission of infection to patients being prevented by hand decontamination immediately prior to touching a patient and before contact with a susceptible site such as a wound or invasive device.1, 3 A methodology for prompting hand hygiene at critical points in the delivery of patient care has been adopted worldwide as the framework for infection prevention and control (IPC) education on hand hygiene.1, 4 The introduction of universal precautions (UP), followed by the concept of body substance isolation, was an important development in IPC as it signalled the introduction of latex and vinyl gloves into routine clinical activity.5, 6, 7 Subsequently national guidelines advised the use of gloves as part of standard IPC precautions to prevent exposure to blood and body fluids (BBF) based on a risk assessment.3, 8, 9 Studies have tended to focus on compliance with glove use in relation to UP and isolation policy, and have identified as problematic the failure to remove or change gloves in a timely manner, as well as low rates of glove removal between procedures and patients during routine care.10, 11, 12 Guidance on glove use emphasizes the importance of changing gloves between procedures and patients and carrying out hand hygiene following their removal.3 However, World Health Organization (WHO) guidance and observation tools do not explicitly integrate the use of gloves within the framework of ‘My five moments of hand hygiene’ (M5M).1, 4 Incorrect use of gloves, such as failure to change them between patients or between different sites on the same patient, combined with inadequate hand hygiene after use, is potentially hazardous and may result in the transmission of micro-organisms to the patient via gloved hands. The small number of studies highlighting failures to remove or change gloves between patients or prior to aseptic procedures have been undertaken in the context of contact precautions, and have provided limited insight into the reasons for these failures.10, 11, 12 The aims of this study were to determine the current context for the general use of gloves in an acute care setting, the extent to which their use is associated with compliance with M5M and risks of cross-transmission, and the factors that influence HCWs' decisions to wear gloves. Section snippetsMethodsThe study was conducted in two phases: an observational audit of how HCWs use clinical non-sterile gloves followed by qualitative semi-structured interviews with clinical staff. The observational audit was undertaken as part of an infection control audit in six wards in an acute, teaching National Health Service trust in the UK between October and December 2011. Wards were selected to provide a balance of surgical, medical and acute care specialties. The audit was conducted in 60–90 min Glove auditIn total, 163 episodes of glove use were observed during a total of 13 h of audit on the six wards. Overall, 48.5% (79/163) of observations took place in intensive care unit (ICU)/high dependency unit (HDU) and 51.5% in general medical/surgical wards (Table III). Overall glove use was appropriate on 42% (69/163) of occasions. In 33% of episodes the procedure was considered high risk for exposure to BBF, and in these cases glove use was recorded as appropriate. However, for 99% of the low-risk and DiscussionThis study is the first to highlight glove-use behaviour that is not connected to actual exposure to BBF, and which appears to be used as an alternative, rather than an adjunct, to hand hygiene. Our observations indicated that not only were gloves often used inappropriately, but that in 37% of episodes glove use increased the risk of cross-contamination because they touched surfaces outside the patient zone before and after contact with a patient. The risk of cross-infection associated with AcknowledgementsWe would like to thank J. Prieto for her advice and insightful comments on the content of this paper. References (26)
Rethinking the role of isolation practices in the prevention of nosocomial infectionsAnn Intern Med(1987) Universal precautionsNurs Times(1990) Infection: prevention and control of healthcare-associated infections in primary and community care(March 2012) 2022, Annals of Medicine and Surgery Show abstractNavigate Down Currently, hospital-acquired infections in healthcare workers and patients are a major concern. On the other hand, sexually transmitted infections and diseases, unwanted pregnancies, and unsafe abortions continue to be a public health concern, particularly in developing countries. Gloves are among the most commonly used personal protective equipment to safeguard healthcare workers' hands from contagious infections, and using a condom is strongly advised for people who have sexual relations with more than one partner. However, the quality of gloves and condoms in developing countries is a subject of concern. The usage of quality test instruments such as glove leakage test apparatus (GLTA), leakage testers by water level, the Ammonia leak testing method (ALTM), conductivity-based leakage testers, and water hang testers in developing countries is limited owing to cost, accessibility, and safety. The main purpose of this study was to develop and test a low-cost integrated device to test glove and condom leakage that is safe and easily accessible in resource poor settings. In this study, an integrated glove and condom leakage testing device for detecting pin holes and leakages is proposed. The device automatically fills a randomly selected condom and glove with a predetermined volume of water based on International Organization for Standardization (ISO) criteria. The prototype of the proposed device was successfully developed and tested. The accuracy of 98.66% for filling condom samples with 300 ml of water and 99.29% for filling glove samples with 1000 ml of water was achieved. The implementation of the developed prototype in resource poor settings to test gloves and condom leakage has the potential to improve the safety of healthcare workers, patients, and the general public. 2022, Journal of Hospital Infection Show abstractNavigate Down An outbreak of VIM carbapenemase-expressing Enterobacter cloacae complex occurred between March and October 2020 in an intensive care unit (ICU) of a tertiary care and teaching hospital in France. At the same time, the hospital was facing the COVID-19 first wave. To describe the management of an outbreak caused by a VIM-producing Enterobacter cloacae complex strain during the COVID-19 pandemic in an ICU and to show the importance of an integrated approach. A multi-focal investigation was conducted including descriptive and molecular epidemiology, environmental screening, and assessment of infection prevention and control measures. A total of 14 cases were identified in this outbreak with a high attributable mortality rate (85.7%). The outbreak management was coordinated by a crisis cell, and involved the implementation of multi-disciplinary actions such as: enhanced hygiene measures, microbiological and molecular analysis of patients and environmental E. cloacae complex strains, and simulation-based teaching. All 23 E. cloacae complex strains isolated from patients and environment samples belonged to multi-locus sequence type ST78 and carried bla-VIM4 gene. Using Fourier transform infrared spectroscopy, all but two isolates were also found to belong to a single cluster. Although the source of this outbreak could not be pinpointed, the spread of the strain was controlled thanks to this multi-focal approach and multi-disciplinary implementation. This investigation highlighted the usefulness of Fourier transform infra-red spectroscopy in the rapid typing of outbreak strains as well as the importance of an integrated approach to successfully fight against multidrug-resistant micro-organism dissemination and healthcare-associated infections. Disinfection of gloved hands during the COVID-19 pandemic2021, Journal of Hospital Infection Show abstractNavigate Down Disinfection of gloves can be used during a pandemic situation when performing various procedures on the same patient or when removing personal protective equipment. If performing glove disinfection, there is a need to check the compatibility of gloves with the disinfectant product used. To test the resistance of nitrile gloves to various disinfectant solutions. One hundred percent powder-free nitrile gloves, composed of nitrile butadiene rubber compounds, were exposed to various disinfectants to analyse resistance. The seven most commonly used disinfectant solutions in the healthcare field were selected for testing. The effects of each disinfectant were analysed in comparison with the control group (untreated glove). For tensile testing, the thickness of each test specimen was measured with a micrometer. Bleach solution decreased the breaking load of gloves, although to a lesser extent than disinfectants that contained ethanol. Disinfectants that contain alcohol decrease the breaking load of nitrile gloves. Continued wearing of gloves: a risk behaviour in patient care2020, Infection Prevention in Practice Show abstractNavigate Down The wearing of gloves is included in the standard principles for preventing healthcare associated infections. A continued wearing of gloves may, however, result in the transmission of organisms instead of preventing infections. Few studies have explored how common it is for surfaces to be touched by potentially contaminated gloves. Secondary analysis of field notes from 48 hours of unstructured observations of healthcare personnel's actions during patient care. The new focus was on to what extent healthcare personnel wore gloves that should have been removed or changed, what surfaces were touched by contaminated gloves and what patient-related activities were involved. A continued wearing of gloves occurred in about half of the observed episodes of patient care. On average, 3.3 surfaces were touched by contaminated gloves. The surfaces most frequently touched were ‘unused single-use items’, ‘equipment controls/switches/regulators/flush buttons’ and ‘bed linen’. This occurred mostly while helping patients with ‘personal hygiene’, when performing ‘test taking’ or during procedures involving the operation of medical or other ‘equipment’. The continued wearing of gloves during patient-related activities carries the risk of organism transmission, as the gloves touch many surfaces. The most critical moments seem to be when the use of gloves is considered essential. A better understanding of the motivators of improper glove-use behaviour is needed to develop interventions that rectify the improper use of gloves. Carbapenemase-producing Enterobacterales outbreak: Another dark side of COVID-192020, American Journal of Infection Control Show abstractNavigate Down In the hospital department dedicated to COVID-19-patient, infection prevention and control measures were upgraded. Therefore, the cross-transmission of other micro-organisms was thought unlikely to occur. However, we report an outbreak of NDM-5-producing Escherichia. coli in a 12-beds ICU dedicated to COVID-19 patients. This outbreak involved 6 patients of which 5 were asymptomatic carriers and 1 was infected. Several findings might have contributed to cross-transmission including the multiple-bedroom configuration of the department, uncomplete compliance for standard and contact precautions, overwork due to the burden of the disease, lack of training of staff for the care of ICU-patients, and misuse of gloves. Furthermore, as infection prevention and control measures were thought to be applied, contact patients were not screened for eXDR carriage. Applying rigorously standard and contact precautions and performing screening in contact patients when indicated must be the rules in COVID-19 wards. Nurse survey, knowledge gaps and the creation of an environmental hygiene protocol for patient transport and removing linen from patient rooms2020, American Journal of Infection Control Show abstractNavigate Down General guidance for personal protective equipment (PPE) is provided by the Occupational Safety and Health Administration and the United States Centers for Disease Control and Prevention. Previous research of PPE demonstrates the ability of gloves to harbor infectious pathogens. We surveyed health care workers to investigate current PPE practices during linen removal from patient rooms and during patient transport. The results suggest a possible risk for cross-contamination of the environment from overuse of gloves. Research article Journal of Hospital Infection, Volume 86, Issue 2, 2014, pp. 90-94 Show abstractNavigate Down Sometimes decisions have to be made even when we do not have all of the information that we would like to have. It is not uncommon for infection control professionals to be faced with an outbreak of colonization or infection while there is uncertainty about the impact of the outbreak on patient outcomes. How do we decide a proportional response when we do not know the seriousness of the outbreak? The precautionary approach has become established in the European Union (EU) as a way of structuring responses to potentially serious threats (such as novel pandemic influenza viruses) when there are substantial uncertainties about the true impact of the threat. The potential of this approach to help with structuring responses to outbreaks involving substantial uncertainties is considered in this article. The EU approach requires that actions should be proportional, non-discriminatory, consistent, take account of costs and benefits, be subject to review, and that the responsibility for producing the scientific evidence to fill critical information gaps is assigned. The example of management of outbreaks with multidrug-resistant Acinetobacter baumannii is used here to illustrate how the precautionary approach might be used in infection prevention and control. The precautionary approach has potential to provide a structured response to outbreaks of hospital infection when there is uncertainty about the impact of the outbreak on outcomes. Most importantly there is a requirement that we specify which risks we are prioritizing for control, the information that is uncertain but critical to informing decisions, and the responsibilities for gathering that information. Research article American Journal of Infection Control, Volume 46, Issue 9, 2018, pp. 1014-1018 Show abstractNavigate Down Exposure to natural rubber latex, primarily through the use of gloves, is a well-recognized cause of occupational asthma. We investigated latex glove use among Australian workers and estimated the resultant burden of occupational asthma among healthcare workers (HCWs). Data were collected in 2014 as part of the Australian Work Exposures Study-Asthma, a telephone survey investigating the prevalence of current occupational exposure to asthmagens, including latex. We estimated adjusted prevalence ratios (aPRs) to determine variables associated with the use of latex gloves among HCWs and calculated the asthma-related disability-adjusted life years due to latex exposure among HCWs. Latex gloves were used by 22% of respondents. Almost two-thirds (63%) of HCWs reported wearing latex gloves, with 26% using powdered latex gloves. The use of latex gloves was more common among those employed in micro companies (less than 5 employees) than large companies (200+ employees) (aPR = 1.5, 95% confidence interval 1.1-2.0). Latex exposure in HCWs was estimated to contribute 3% of the total asthma-related burden. Latex gloves are widely used by Australian workers and by HCWs in particular. This is the first estimate of the burden of asthma attributable to occupational exposure to latex among HCWs. These results can be used to guide decisions regarding the control of occupational exposure to latex. Research article Médecine et Maladies Infectieuses, Volume 44, Issue 6, 2014, pp. 268-274 Show abstractNavigate Down The authors of this randomized study had for aim to evaluate the impact of training on proper glove use by comparing compliance to glove use recommendations between trained and untrained healthcare personnel according to healthcare professional groups. A random selection of trained and untrained nurses, nurse aids, and hospital housekeepers was performed in a French University hospital, using a listing of healthcare personnel. The audits were conducted by two infection control nurses, in series of 10 observations, with a maximum time limit of two hours. The evaluation criteria were compliance or non-compliance of glove-wearing practices with internal hospital recommendations, disclosed to professionals during training. Overall, 111 professionals were audited and 794 acts were observed. Hand hygiene was significantly better in trained vs. untrained healthcare professionals (P < 0.01). Proper glove use practices were similar between trained and untrained nurses (85% of compliance), whereas the difference was statistically significant in favor of trained healthcare personnel for the other categories (P < 0.001 for nurse aids and P = 0.02 for housekeepers). We demonstrated the impact of pluridisciplinary training on proper glove use practices in hospital settings, but with different benefits found according to professional groups. The lower the initial training level, the greater the overall benefit appeared to be. Cette étude randomisée visait à évaluer l’impact de la formation sur le bon usage des gants, en comparant la conformité des pratiques d’utilisation des gants entre personnels formés et non formés selon les différents groupes de professionnels de santé. Dans un hôpital universitaire français, en utilisant la liste des personnels de santé paramédicaux, une sélection aléatoire d’infirmières, d’aides-soignantes et d’agents de service de l’hôpital, formés et non formés, a été effectuée. Les audits ont été effectués par deux infirmières hygiénistes par série de 10 observations, d’un délai maximum de 2 heures. Les critères d’évaluation étaient la conformité ou la non-conformité des pratiques de gantage par rapport au référentiel interne de l’hôpital présenté aux professionnels lors de la formation. Globalement, 111 professionnels ont été audités, avec 794 actes observés. L’hygiène des mains était significativement meilleure chez les formés comparativement aux professionnels non formés (p < 0,01). En ce qui concerne la bonne utilisation des gants, les pratiques étaient similaires entre les infirmières et infirmiers formés et non formés (85 % de conformité), alors que la différence était statistiquement significative en faveur du personnel formé pour les autres catégories (p < 0,001 pour les aides-soignantes et p = 0,02 pour les agents de service hospitalier). Cette étude démontre l’impact d’une action de formation multidisciplinaire sur la bonne utilisation des gants à l’hôpital, mais avec des bénéfices différents selon les catégories de professionnels de santé. Le bénéfice semble d’autant plus grand que le niveau initial de formation est modeste. Research article A study of clinicians’ views on medical gloves and their effect on manual performanceAmerican Journal of Infection Control, Volume 42, Issue 1, 2014, pp. 48-54 Show abstractNavigate Down The effect of gloves on practitioners’ performance has not been a major factor in their design. To determine the critical elements of performance and design appropriate tests, data from clinicians were needed. Semistructured interviews were carried out with medical practitioners from various disciplines, in which they were asked about their glove use, their views on gloves, medical tasks requiring the highest manual performance or most affected by gloves, and what the main issues with glove use were. Many participants expressed a preference for latex over nitrile, with glove fit being the main reason given. Satisfaction with surgical gloves (generally latex) was high but less so with examination gloves, which were generally nitrile. Tactile sensation, comfort, and donning were also seen as major issues with glove use. A number of tasks were identified for possible development as tests. Performance in medical practice needs to be clearly defined, separating perceived and measured performance, and understanding the effect of glove material, fit, and thickness. Development of new glove performance tests based on the tasks identified is an important part of this. Research article Hand hygiene compliance in a universal gloving settingAmerican Journal of Infection Control, Volume 45, Issue 8, 2017, pp. 830-834 Show abstractNavigate Down The use of gloves for every patient contact (ie, universal gloving) has been suggested as an infection prevention adjunct and alternative to contact precautions. However, gloves may carry organisms unless they are changed properly. In addition, hand hygiene is required before donning and after removing gloves, and there are scarce data regarding glove changing and hand hygiene in a universal gloving setting. This nonrandomized observational before-after study evaluated the effect of education and feedback regarding hand hygiene. Compliance with hand hygiene and glove use was directly observed in a universal gloving setting at a 10-bed intensive care unit in a Japanese tertiary care university teaching hospital. A total of 6,050 hand hygiene opportunities were identified. Overall, hand hygiene compliance steadily increased from study period 1 (16.1%) to period 5 (56.8%), although there were indication-specific differences in the baseline compliance, the degree of improvement, and the reasons for noncompliance. There were decreases in the compliance with universal gloving and the incidence of methicillin-resistant Staphylococcus aureus. It is difficult to properly perform glove use and hand hygiene in a universal gloving setting, given its complexity. Direct observation with specific feedback and education may be effective in improving compliance. Research article Hand hygiene compliance before and after wearing gloves among intensive care unit nurses in IranAmerican Journal of Infection Control, Volume 44, Issue 11, 2016, pp. e279-e281 Show abstractNavigate Down Nosocomial infections are considered a major risk factor in hospital wards, and hand hygiene is the first step in their control. An observational study was conducted in 2015 with 200 nurses working in intensive care units in teaching hospitals of Tabriz, Iran. Data were collected by using the Hand Hygiene Observation Tool questionnaire. The researchers monitored nurses' opportunities for hand hygiene during the 8-week period from February 3-April 4, 2015. A total of 1,067 opportunities occurred for hand hygiene before and after wearing gloves. The results show that hand hygiene compliance before wearing gloves is poor among nurses who work in intensive care units (14.8%). Therefore it is necessary to conduct effective interventions through continuing education programs to improve hand hygiene compliance. When removing soiled gloves which action should the nurse take?When removing soiled gloves, which should the nurse do first? Grasp the outside of one glove with the opposite gloved hand. Explanation: When removing soiled gloves, the nurse would grasp the outside of one glove with the opposite gloved hand and peel it off, turning the glove inside out as it is pulled.
When removing sterile or clean gloves Why should the nurse turn the gloves inside out?Doing this, prevents the contamination of the hand when removing glove. 14. Take ungloved hand, place fingers inside the other glove, and pull glove off inside out. This step prevents the contamination of gloved hand touching ungloved hand.
Which of the following is an important practice when removing gloves quizlet?Which of the following is an important practice when removing gloves? Only touch glove to glove and skin to skin.
When should barrier gloves be removed?Gloves are for single-client use and must be removed after caring for one client. Reuse of gloves has been associated with transmission of antibiotic-resistant organisms. Change or remove gloves if moving from a contaminated site to a non-contaminated site on the same person or if touching the environment.
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