All about gloves in hand hygiene

 

When to wear gloves?

According to the WHO [1], there are 3 major indications for glove usage:

  • Contact with blood or other body fluids
  • Touching patient during contact precautions
  • Before sterile condition

When to remove?

  • If the glove is damaged
  • If contact with blood, body fluid, mucous membrane has ended
  • If contact with a contaminated body site on a patient ended
  • If there is an indication of hand hygiene [1]

A study found, that the number of micro perforations increased with the duration of wearing, so they suggest a 15 minutes time limit [2]

When to perform hand hygiene?

HCW should perform hand hygiene before donning gloves and after doffing it. Glove usage cannot replace hand hygiene or anyhow modify hand hygiene indications, so hand hygiene must be performed according to the WHO 5 moments of hand hygiene [1].

Do healthcare-workers (HCW) comply with these rules?

  • Gloves usage is incorporate in 42% of episodes [3]
  • HCW did not change gloves in 64% of cases before caring for a new patient [4]
  • Only 25% changed gloves between procedures on the same patients [5]]
  • Wearing gloves can decrease hand hygiene compliance [6]

What type of glove should we choose?

  • Powdered examination and surgical gloves was banned by the FDA in 2017 [7]
  • Many people have allergy to latex, they must wear latex-free gloves [8]
  • Both nitrile and latex gloves have advantages; a study found that nitrile gloves have less perforations [9], but latex gloves has superior barrier effect against bacterial transmigration [2]

Can we use handrub on gloves?

  • Most authorities do not recommend this practice.
  • In practice, it still seems to be wide spread
  • According to the Robert Koch Institute (Germany) disinfection of gloved hand can be acceptable [10]
  • Handrubs have different compositions, and gloves also made of different materials. Some products can be incompatible [11] A study claim, that latex gloves with ethanol seemed to be the best pair [12] German Aktion Saubere Hände (Clean Hands Action) only allows decontamination of nitril glove.
  • Gloves are labeled as a single use product, “intended for one use, or for use on a single patient during a single procedure”. Reusing gloves is also a legal issue [11].