Hand Hygiene Handwashing and Clean Hands Saves Lives


Medical Exam Gloves Causing Reduced Hand Hygiene Compliance

Is it true that medical gloves can have a detrimental effect on hand hygiene compliance? I can understand how confusing this statement is. After all, aren’t exam gloves suppose to provide protection against the spread of infections? A recent study published in the Infection Control and Hospital Epidemiology observed that the rate of healthcare workers practicing hand hygiene when exam gloves were used was worse than when medical gloves were not worn. These findings reinforce the idea that we need to keep vigilant with educating everyone on when hand hygiene should be practiced and the importance of it.

In The Dirty Hand in the Latex Glove study, the hand hygiene compliance rate of healthcare workers who used medical gloves was 9% worse than the workers who didn’t wear exam gloves. The study concluded that there was a strong association of medical gloves being used as the reason for this discrepancy. This seems to indicate that there are numerous healthcare professions who believe donning medical gloves alone are sufficient for proper hand hygiene. Similar to drivers who are more inclined to speeding feeling protected by air bags, many of us have grown comfortable with the idea of being sufficiently protected by medical gloves. Just as wearing seat belts is the best protection for drivers, washing our hands is the best protection against hospital acquired infections. Wearing medical gloves is not suppose to act as a substitute for washing hands or using hand antisepsis, but rather be a complementary process for maintaining good hand hygiene practices.

Another reason for the decline in the rate of hand hygiene compliance is attributed to the lack of education of when gloves should be used and when hands should be cleaned with soap & water or alcohol rub. It is easy for us to remember that gloves should be used in high-risk scenarios and that hands should be washed when they are visibly contaminated, but what about the times when you are not in a high-risk scenario or when your hands are not visibly dirty? What is even considered to be a high-risk scenario? Considering how busy healthcare workers are, it is understandable that we would forget over time.

The World Health Organization (WHO) recommends that hands need to be cleaned before donning medical gloves and after taking them off. The WHO recommends that medical gloves should be used whenever you anticipate coming into contact with bodily fluids or when patients need to be protected in a sterile environment. The purpose of medical gloves is to provide barrier protection against harmful microbes, not eliminate them. It is important for everyone to understand gloves may contribute to the spread of infections if proper hand hygiene procedures are not practiced, such as changing exam gloves for new patients and cleaning hands before and after donning gloves.

At the end of the day, continued education of when and how to practice proper hand hygiene is important. Just because a nurse received training at the start of employment does not mean she will retain the information several years later. Let’s be sure our colleagues understand that exam gloves are not a substitute for hand hygiene and that we should be cleaning our hands before and after wearing them. Let’s bring the rate of healthcare acquired infections down to 0. Clean hands save lives!

Hand Hygiene References
  • Fuller, Christopher. "The Dirty Hand in the Latex Glove": A Study of Hand Hygiene Compliance When Gloves Are Worn. Infection Control and Hospital Epidemiology. November 11, 2011.
  • World Health Organization. World Health Organization on Hand Hygiene. Geneva: WHO, 2009.