Credit WHO Hand Hygiene Campaign
# 7438
Although individually packaged sterile gloves are recommended for surgery, suturing, or other highly invasive procedures, most of the time clinicians and health care workers (HCWs) will don a pair of non-sterile exam gloves, usually pulled from an open dispenser, when interacting with patients.
Today, we’ve a study appearing in the Australasian Medical Journal – conducted by researchers from New Zealand’s University of Otago – that found significant levels of bacterial contamination are introduced into these dispensers over time.
It turns out that poor hand hygiene by hospital staff - combined with the current design of these glove box dispensers – are likely to facilitate the transfer of dangerous bacteria to unused gloves.
World Health Organization (and other) guidelines emphasize the need for good hand hygiene before donning gloves, but compliance among HCWs has historically been low.
Source WHO Glove Use Guidance
First a link to the study and some excerpts from the abstract, then I’ll return with a bit more.
Bacterial Contamination of Unused, Disposable Non-sterile Gloves on a Hospital Orthopaedic Ward
Jon Cornwall, Kim Hughes, Jean-Claude Theis, Heather Brooks
Abstract
Background
Non-sterile disposable gloves are used on large hospital wards, however their potential role as a vehicle for pathogen transmission has not been explored in this setting.
<SNIP>
Results
Total bacterial counts ranged from 0 to 9.6 x 103 cfu/glove. Environmental bacteria, particularly Bacillus species, were present on 31/38 (81.6%) of samples.
Half (19/38) the samples were contaminated with skin commensals; coagulase negative staphylococci were predominant. Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas sp. or methicillin susceptible Staphylococcus aureus were recovered from 5/38 (13.2%) of samples.
Significantly more skin commensals and pathogens were recovered from samples from days 3, 6, 9 than box-opening samples. Staphylococcus epidermidis and Klebsiella pneumoniae inoculated onto gloves remained viable for several days but counts decreased.
Conclusion
Health-care workers introduced skin commensals and pathogenic bacteria into glove boxes indicating that unused, non-sterile gloves are potential pathogen transmission vehicles in hospitals. Findings highlight adherence to hand-washing guidelines, common glove retrieval practice, and glove-box design as targets for decreasing bacteria transmission via gloves on hospital wards.
From the full text of this study, we get the following summary:
What this study adds:
1. In a hospital ward setting, unused non-sterile disposable gloves (NSDG) may become contaminated with skin commensals and pathogens during the act of glove retrieval.
2. Contaminated NSDG therefore have the potential to act as transmission vehicles for bacteria as demonstrated by these results.
3. Glove box design and glove withdrawal technique could be further examined to decrease the potential for pathogen transfer to unused gloves.
In the fall of 2011 we looked at a study published in Infection Control and Hospital Epidemiology (see A Barrier To Good Hand Hygiene) that found that exam glove use may actually decrease HCW compliance with good hand hygiene practices.
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%.
Studies have shown that although compliance rates are improving, 50% of health care workers in the United States fail to consistently wash their hands between patients (cite).
For more on the challenge of preventing Hospital Acquired Infections you may wish to visit the CDC’s HAI PAGE.
Or revisit some of these earlier blogs on hospital acquired infections.
HPA: Healthcare-Associated Infection (HCAI) Survey
Study: Hospital Uniforms And Bacteria
Study: HAIs, Universal Surveillance, & MRSA
