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Nursing home workers often fail to change gloves, risking spread of infection

  • 3 Comments

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”

Linda Greene

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.”  

Association for Professionals in Infection Control and Epidemiology

Concerns raised over infection risk from endoscopes

Linda Greene

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.

  • 3 Comments

Readers' comments (3)

  • I train staff in nursing homes. When I tell them the correct use of gloves, I have on several times been told by staff that they are not allowed to use gloves correctly and must use the same pair if they aren't visibly dirty! I once witnessed a staff member having worn gloves to change a soiled pad, go to was the gloves (with the gloves on her hands), and continue to use them to prepare food! Obviously I stopped her and reported to the manager. There is such a ridiculous underfunding in care, that incredibly unsafe practices are a daily occurrence. I've been in nursing for 40 years and I've never seen such shocking practices due to lack of funding.

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  • I feel that the wearing of gloves reassures the wearer that they are no longer vulnerable to contamination with the result that the patient - in a medical, surgical, dental or social setting - is subjected to even greater exposure to disease.

    Perhaps it's time to have a universal colour coding? Red for unhygienic procedures and green for food areas for starters...

    Can the gloves be specific to the patient? For example, would its be feasible to change an incontinence pad wearing red gloves, wear the gloves to wash and dry them using disposable towels/ air dry, then keep the gloves with that specific person's continence pads? Replace them each day? Not ideal but at least it would reduce cross infection.

    It all comes down to too little government money for the basics. Short termism again from the untouchables in their ivory towers.

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  • I'm really not sure how much relevance a study carried out in US nursing homes has in the UK?

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