Inappropriate glove use endangers residents and staff

According to the Centers for Disease Control and Prevention, as many as 380,000 residents die of infections in long-term health care facilities each year. Hand hygiene, including the use of medical gloves, is imperative to preventing the spread of germs and protecting residents from illness. However, inappropriate use of gloves endangers both residents and those who care for them. To promote a safer health care environment, it is essential that skilled care nursing staff know when and how to properly use gloves. A few simple steps can help caregivers reduce the danger of spreading infection and protect residents from illness.

When to use gloves
Multiple studies have proven that the use of medical gloves reduces the spread of germs in health care settings. However, gloves are not to be substituted for consistent hand hygiene practices. According to the World Health Organization (WHO), medical gloves should be used “during all patient-care activities that may involve exposure to blood and all other body fluid (including contact with mucous membrane and non-intact skin), during contact precautions and outbreak situations.” When contact with blood, body fluid, non-intact skin and mucous membrane ends, gloves need to be taken off, according to WHO. They should also be taken off when contact with a single resident, their surroundings and/or a contaminated body site ends. Finally, gloves should be taken off when they sustain damage or when hand hygiene needs be performed.
Germs can also be spread when gloves are not changed at appropriate times. In a study written about by the Association for Professionals in Infection Control and Epidemiology, it was found that failure to change gloves was common among long-term care certified nursing assistants (CNAs). According to the article, “CNAs must change gloves as a standard precaution at the following glove change points during patient care: when the gloves have touched blood or body fluids; after the CNA completes a patient task; after the gloves touch a potentially contaminated site; and in between patients.” Contaminated gloved touches significantly increase the potential for cross-contamination between residents and their environment.

How to wear gloves
Before putting on gloves, hands should be thoroughly washed with soap and water or an alcohol-based hand sanitizer. For ease of putting on gloves, the hands should be completely dry. No oil-based hand creams or lotions should be used unless they are approved for use with latex gloves. Rings and wrist jewelry should be removed. Nursing staff need to wear the appropriate size glove that allows them to comfortably perform all resident care activities. When putting on the glove, the outside should be touched as little as possible. WHO recommends grabbing gloves by the top edge of the cuff to pull them on the hands without touching the skin of the forearm. Non-latex gloves should be worn if the resident or the staff member providing care is allergic to latex.

Long-term care staff can also endanger themselves and others by not properly taking off their gloves. To take off gloves, the following procedure is recommended:

  • Grab the outside top of the right glove with the left hand.
  • Pull toward the fingertips. The glove will turn inside out.
  • Hold onto the empty glove with the left hand.
  • Put two right-hand fingers in the top of the left glove.
  • Pull toward the fingertips until the glove has been pulled inside out and off the hand. The right glove will be inside the left glove now.
  • Throw the gloves away in an approved waste container.
  • Wash with soap and water or with an alcohol-based hand sanitizer.

Consistent hand hygiene coupled with appropriate glove use protects residents and staff from infections. Facilities must commit to the promotion of proper glove usage by continually educating staff on how to avoid poor habits, such as not changing gloves. Best practices along with ongoing vigilance will keep both residents and staff safer.

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