VOL: 102, ISSUE: 24, PAGE NO: 44
Shila Patel, MSc, RGN, is clinical nurse specialist infection control, Epsom and St. Helier University Hospitals NHS Trust
The Health and Safety at Work Act (1974) is the legislative framework that underpins the use of gloves in healthcare. The act places a legal responsibility on employers, as far as is reasonably possible, that all employees are provided with a safe working environment, safe systems of work and safe equipment. Given that healthcare workers routinely encounter blood and body fluids, all of which are known to be a transmission route for infectious agents, employers have a responsibility to provide gloves as a means of providing a safe working environment.
Alongside this legislative framework, national evidence-based guidelines for preventing healthcare associated infections (Pratt et al, 2001) identify two main indications for glove use:
- To protect the hands of healthcare workers from contamination with organic matter, such as faeces and vomit, as well as from microbial contamination;
- To reduce the risk of further transmission of micro-organisms to both patients and staff.
Also, the Hospital Infection Society (2001) has identified that some types of gloves protect the skin against hazardous substances, such as certain chemicals.
A decision as to whether to use gloves should be based on an assessment of the risk associated with the care activity to be undertaken and the potential for contamination with body fluids, micro-organisms and hazardous chemicals.
Gloves are manufactured as single-use items, and reprocessing them by washing is contrary to manufacturers’ instructions. Wearing gloves is not a substitute for thorough hand decontamination.
Principles of glove-wearing
Gloves must be put on immediately before undertaking a procedure and removed immediately after it. If they are put on before collecting equipment they will become contaminated. Equipment should therefore be collected first and placed at the patient’s bedside ready for use. The nurse’s hands should then be washed and the gloves put on immediately before undertaking the procedure. They should be removed immediately after finishing it to prevent cross-contamination of the environment.
These principles can also be applied when several procedures are carried out on the same patient (Wilson, 2001). For example, gloves worn to clean faecal incontinence must be changed before emptying a urinary catheter bag on the same patient. Failure to do so can result in micro-organisms from the bowel being transferred into the urinary tract, where they may cause an infection. Gloves must always be changed between patients as they are an infection risk.
A variety of materials, both natural and synthetic, are used to manufacture disposable gloves (Infection Control Nurses Association, 2002). Irrespective of the material from which gloves have been manufactured, they must comply with the minimum standards that have been laid down by the British Standards Institution (2000). They should carry the CE mark.
When selecting gloves, consideration should be given to a variety of issues; for example, the activities to be undertaken, the level of cross-infection risk associated with those activities, and staff and patient sensitivity to the material from which the gloves have been manufactured. Latex in particular is associated with sensitisation (Booth, 1996), and it is advisable to have alternatives to latex gloves available for staff or patients who may have latex sensitivity (Table 1).
The Infection Control Nurses Association (2002) recommends that gloves be stored in a temperature that ranges from 5 degsC to 30 degsC and in an atmosphere with humidity less than 65%. Inappropriate storage can lead to deterioration of the glove material; it may become brittle, and the gloves may not then provide adequate protection.
Gloves should be kept in their original box, and taken from it as and when required. They must not be decanted into an open container, and they must not be put in uniform pockets. A purpose-designed wall-mounted rack will allow for accessibility. Boxes of gloves must not be stored on windowsills and on top of dustbins.
Disposable gloves offer protection from blood and body fluids, but inappropriate use increases the risk of cross-contamination and may also reduce hand hygiene compliance.
- This article has been double-blind peer-reviewed.
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