Failure to change gloves is common among nursing assistants and may be a significant cause of the spread of dangerous pathogens in nursing homes and similar settings, according to a US study.
Researchers from the University of Iowa College of Nursing assessed glove use in 74 nursing assistants performing toileting and perineal care at a long-term care facility.
“Glove use behaviour should be monitored alongside hand hygiene”
Deborah Patterson Burdsall
Inappropriate glove use – defined as a failure to change gloves, and when surfaces were touched with contaminated gloves – was frequently observed in the study, they said.
Under US national guidance, assistants must change gloves as a standard precaution when they have touched blood or body fluids, after they complete a patient task, after they touch a potentially contaminated site, and in between patients.
To measure inappropriate glove use, the study authors developed the Glove Use Surveillance Tool (GUST). This allowed them to record the type of surface, the sequence in which staff touched surfaces during a patient care event, whether they wore gloves, and whether they changed gloves.
While nursing assistants wore gloves for 80% of touch points, they failed to change gloves at 66% of glove change points, said the researchers.
More than 44% of the gloved touch points were observed as contaminated, with all contaminated touches being with gloved hands.
“Facilities must continually educate healthcare providers about the importance of appropriate glove use”
Of note, said the researchers, was that gloves were readily available on all units in public areas, shower rooms, patient rooms, and patient bathrooms to enhance availability and workflow.
The frequency of contaminated gloved touches showed the significant risk of cross-contamination between patients and the healthcare environment from inappropriate glove use, they said.
They added that their findings supported results from earlier studies that described inappropriate glove use by healthcare personnel.
They called on infection prevention staff and educators to develop training programmes using adult learning principles and evidence-based instructional methods to improve glove use.
Lead study author and nurse Deborah Patterson Burdsall said: “Glove use behaviour is as important as hand washing when it comes to infection prevention.
“These findings indicate that glove use behaviour should be monitored alongside hand hygiene,” she said. “The observations should be shared with staff to improve behaviours and reduce the risk of disease transmission.”
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The new study has been published in the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).
Linda Greene, registered nurse and president of APIC, said: “Gloves are an essential component of standard precautions, and proper use of gloves is a critical component of best practices to prevent HAIs.
“This is especially important in long-term care, where residents are more vulnerable to infection and stay for extended periods,” she said.
“Facilities must continually educate healthcare providers about the importance of appropriate glove use to prevent infection and monitor adherence to this practice,” she added.