title: Misuse of gloves: the foundation for poor compliance with hand hygiene and potential for microbial transmission?
abstract: Improvement in hand hygiene compliance is important for reducing cross-infection by micro-organisms. The objective of this prospective observational study was to measure how the improper use of gloves limits compliance to hand hygiene and exposes patient's to infection. The study was conducted in five wards (three intensive care units and two medical wards) in a French university hospital. Staff-patient and staff-environment contacts were observed in 120 healthcare workers caring for patients colonized or infected with pathogenic bacteria. Hand hygiene was not undertaken due to improper gloving in 64.4% (95%CI, 64.1% to 65.1%) of instances. Possible microbial transmission might have occurred in 18.3% (95%CI, 17.8% to 18.8%) of all contacts because used gloves were not removed before performing care activities that necessitated strict aseptic precautions. Failure to change or remove contaminated gloves was a major component in the poor compliance with hand hygiene and carried a high-risk of microbial transmission. Improving hand hygiene compliance will require changing healthcare workers behaviour towards glove use.
authors.affiliation: Infection Control Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France. emmanuelle.girou@hmn.ap-hop-paris.fr
authors.forename: E
authors.initials: E
authors.lastname: Girou
authors.forename: S H T
authors.initials: SH
authors.lastname: Chai
authors.forename: F
authors.initials: F
authors.lastname: Oppein
authors.forename: P
authors.initials: P
authors.lastname: Legrand
authors.forename: D
authors.initials: D
authors.lastname: Ducellier
authors.forename: F
authors.initials: F
authors.lastname: Cizeau
authors.forename: C
authors.initials: C
authors.lastname: Brun-Buisson
mesh_terms: D000891:Anti-Infective Agents, Local; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D005602:France; D017575:Gloves, Protective / Q000382:microbiology* / Q000706:statistics & numerical data; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000592:standards*; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D006920:Hygiene / Q000592:standards*; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D016106:Methicillin Resistance; D009728:Nursing Assistants / Q000592:standards; D009741:Nursing Staff, Hospital / Q000592:standards; D011446:Prospective Studies; D018570:Risk Assessment; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000891:Anti-Infective Agents, Local