title: Clinical glove use: healthcare workers' actions and perceptions.
abstract: BACKGROUND
  The incorrect use of clinical gloves and the failure to change them between procedures increases the risk of cross-transmission. Much attention has been focused on compliance with hand hygiene.
  
  
  OBJECTIVE
  To investigate the use of gloves, their potential for cross-contamination, and factors that influence the decision of healthcare workers (HCWs) to wear them.
  
  
  METHODS
  The use of gloves was observed in six wards in a single UK hospital trust. Risk of cross-contamination was defined as a violation of a 'moment of hand hygiene' during the glove-use episode. Twenty-five HCWs from the wards included in the observational audit were interviewed to identify the drivers for glove use.
  
  
  RESULTS
  A total of 163 glove-use episodes were observed over a period of 13 h. Glove use was inappropriate in 69 out of 163 (42%) episodes, with gloves commonly used inappropriately for low-risk procedures (34/37; 92%). In 60 out of 163 (37%) episodes of glove use there was a risk of cross-contamination, most (48%) being associated with failure to remove gloves or with performing hand hygiene after use. HCW interviews indicated that the decision to wear gloves was influenced by both socialization and emotion. Key emotions were disgust and fear. Assumptions that patients preferred gloves to be used, confusion about when to wear them, and social norms and peer pressure were also important influences.
  
  
  CONCLUSIONS
  Glove use is associated with risk of cross-contamination and should be more explicitly integrated into hand hygiene policy. An understanding of the drivers of glove-use behaviour is required to design interventions to reduce misuse and overuse.
authors.affiliation: Richard Wells Research Unit, University of West London, London, UK.
authors.forename: H P
authors.initials: HP
authors.lastname: Loveday
authors.affiliation: Richard Wells Research Unit, University of West London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Lynam
authors.affiliation: Infection Prevention & Control Department, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Singleton
authors.affiliation: Institute of Practice, Interdisciplinary Research & Enterprise, University of West London, London, UK. Electronic address: jennie.wilson@uwl.ac.uk.
authors.forename: J
authors.initials: J
authors.lastname: Wilson
mesh_terms: D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control*; D017575:Gloves, Protective / Q000706:statistics & numerical data*; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D006113:United Kingdom
keywords: Behaviour; Cross-contamination; Gloves; Hand hygiene; Healthcare workers