Friday, November 04, 2011

A Barrier To Good Hand Hygiene




# 5939



It sounds counter-intuitive. 


That the use of latex (or vinyl) gloves could contribute to reduced hand hygiene compliance in health care settings. 


But that is exactly what a study - published in the December issue of Infection Control and Hospital Epidemiology – has uncovered.


The study, which was conducted at 15 hospitals in the UK, found that hand hygiene compliance – even in this age of heightened awareness of infection control - was `disappointingly low’.


Overall hand hygiene compliance was observed to be just 47.7%, while the use of gloves was associated with a further decrease to just 41%.


It would appear that the use of gloves can lead to a false sense of security, and the result is a reduction in hand hygiene.


The following press release comes from SHEA, the  Society for Healthcare Epidemiology of America. 


Latex gloves lead to lax hand hygiene in hospitals, study finds

CHICAGO -- Healthcare workers who wear gloves while treating patients are much less likely to clean their hands before and after patient contact, according to a study published in the December issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. This failure of basic hand hygiene could be contributing to the spread of infection in healthcare settings, the researchers say.


Glove use is appropriate for situations when contact with body fluids is anticipated or when patients are to be managed with contact precautions. However, use of gloves should not be considered a substitute for effective hand hygiene practices taking place before and after patient contact. Although gloves can reduce the number of germs transmitted to the hands, germs can sometimes still get through latex. Hands can also be contaminated by "back spray" when gloves are removed after contact with body fluids.


The researchers, led by Dr. Sheldon Stone of the Royal Free Hospital NHS Trust, observed more than 7,000 patient contacts in 56 intensive care and acute care of the elderly wards in 15 United Kingdom hospitals, making this one of the largest and most detailed studies on gloves and their impact on hand hygiene. Overall, the study found that hand hygiene compliance was "disappointingly low," at just 47.7 percent. Compliance was even lower in instances where gloves were worn, dipping to just over 41 percent.


"The chances of hands being cleaned before or after patient contact appear to be substantially lower if gloves were being worn," said Dr. Stone, the principal investigator. "We call this the phenomenon of the 'Dirty Hand in the Latex Glove.'"

(Continue . . . )


Cite: Christopher Fuller, Joanne Savage, Sarah Besser, Andrew Hayward, Barry Cookson, Ben Cooper, Sheldon Stone. The Dirty Hand in the Latex Glove: A Study of Hand-Hygiene Compliance When Gloves Are Worn. Infection Control and Hospital Epidemiology 32:12 (December 2011)


Given the huge burden of HAIs (Hospital Acquired Infections), the subject of hand hygiene comes up frequently in this blog. 


You’ll find a lot more on this subject in last month’s Giving Germs A Helping Hand, which looked at low handwashing compliance among doctors and other healthcare providers.


On May 5th of this year the World Health Organization promoted a CLEAN YOUR HANDS DAY  to encourage HCWs to improve and sustain hand hygiene practices around the world.


Clean Care is Safer Care
First Global Patient Safety Challenge
Clean Care is Safer Care


Additionally, the CDC’s hand hygiene website  has many resources, including a link to a new iPad/iPhone application called iScrub.




To round out this entry, some oldies but goodies from the AFD archives.

Doing The Hand Jive
Hand Hygiene Among Doctors Exposed
Gonna Wash Those Germs Right Off Of My Hands

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