hand hygiene
By Paul Alper
Gloves: An Essential Component
of Proper Hand Hygiene
J
ust as important as proper cleaning and sanitizing of hands,
is proper glove use in the prevention of HAIs. This month’s
column will address the when, why and how of glove use as
an essential element of your overall infection prevention and
control strategy and keeping everyone in your community of
patients, visitors and staff safe.
While there are a variety of gloves used in healthcare, we
will address the proper use of non-sterile, single use (disposable)
exam gloves and their role in protection of the patient as well
as the healthcare provider.
Complete Hand Hygiene Education
Hand hygiene education must include instruction on proper
glove use, not just when and how to perform hand washing
or sanitizing. Wearing gloves does not replace proper hand
hygiene practices but should be used as indicated according
to accepted guidelines and those of your facility.
Using an alcohol based hand sanitizer before donning
gloves is essential to ensure no contamination of other
gloves in the box as they are removed from the original box
or storage container.
Guidelines and Recommendations – When to Wear/
When to Remove or Change
The WHO (World Health Organization), CDC (Centers for
Disease Control) and OSHA (Occupational Safety & Health
Administration) all recommend glove use during a procedure
or task when contact is likely: with blood or bodily fluids;
with mucous membranes; with non-intact skin; with other
potentially infectious materials and when handling or touching
contaminated equipment or surfaces.
Knowing when to remove or change gloves is just as
important as when to wear them. Gloves protect the healthcare
worker as well as the patient but they also pose a risk if not
removed when contaminated. Timing of and technique for
donning and doffing of gloves is essential to eliminating the
risk of HAI transmission.
The CDC, WHO and OSHA all have recommendations
regarding removing and changing of gloves including:
• Remove gloves:
• After caring for a patient especially when contact with
blood, other body fluids, non-intact skin and mucous
membranes has occurred and ended
• When there is an indication for hand washing or sanitizing
• Change gloves when damaged or suspected of being
damaged and when moving from care on a soiled body
site to a clean body site on the same patient
• Do not wear the same pair of gloves for the care of
more than one patient (this also means never washing
them between patients)
• Carefully remove gloves to prevent hand contamination
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Common Usage Errors
Common errors with proper glove use include prolonged
use which can result in the transmission of disease causing
microorganisms due to a possible failure to identify an
indication for hand hygiene and then performing it.
Gloves should not be worn when there is no potential
for exposure to blood or body fluids, mucous membranes,
non-intact skin or contaminated environmental surfaces.
Skin Health and Gloving
Occupational dermatitis is a common issue among
healthcare workers. High frequency hand hygiene can
potentially remove protective lipids from the skin, making
it more prone to drying and irritation as well as colonization
with disease causing bacteria.
Proper and frequent use of a latex and nitrile compatible
lotion, especially at the start and end of the shift, along with
the use of gloves manufactured with therapeutic additives
such as oatmeal and aloe are two ways to reduce the risk
as well as help soothe and recover hands that have become
dry, chapped and irritated.
Importance of Glove Size
Selecting proper sized gloves is essential to achieving
proper protection. In general, gloves should cover the entire
hand and wrist and feel snug without being too tight and
allow full movement of the hand and fingers. Be sure to
follow the manufacturer’s guidance on how to properly fit
each healthcare worker on your staff.
Steps to Take, Now
• Review your facility’s hand hygiene training and edu-
cation and be sure that proper use of gloves is adequately
covered including demonstrations for proper donning and
doffing technique
• Use direct observation not only for measuring hand
hygiene compliance but proper glove use adherence, taking
the time for interventional feedback when errors occur; make
unit leadership accountable for this practice
• Foster a psychologically safe patient safety culture so that
healthcare workers feel safe talking to anyone at any level
about their proper use of gloves as well as hand hygiene
Paul Alper, BA, led the launch of PURELL®, invented the
first electronic hand hygiene monitoring system proven to
reduce infections while improving behavior and eliminating
costs and is now the VP Patient Safety Innovation for
Medline Industries, Inc. through an exclusive engagement
with his consulting practice, Next Level Strategies, LLC.
He can be reached for questions or comments at paul@
next-levelstrategies.com.
february 2020 • www.healthcarehygienemagazine.com