The World Health Organization has laid down the various procedures for use of gloves in order to prevent germ transmission.
Medical gloves are recommended to be worn for two main reasons:
- To reduce the risk of contamination of healthcare workers’ hands with blood and other body fluids
- To reduce the risk of germ dissemination to the environment and of transmission from the healthcare worker to the patient and vice versa, as well as from one patient to another
The efficacy of gloves in preventing contamination of the hands of healthcare workers and helping to reduce transmission of pathogens in healthcare has been confirmed in several clinical studies. Nevertheless, healthcare workers should be informed that gloves do not provide complete protection against hand contamination. Pathogens may gain access to the caregivers’ hands via small defects in gloves or by contamination of the hands during glove removal. Hand hygiene by rubbing or washing remains the basic to guarantee hand decontamination after glove removal.
Prolonged use of gloves for contact precautions in the absence of considering the need to perform hand hygiene can result in the transmission of germs.
Glove use and the need for hand hygiene
- When an indication for hand hygiene precedes a contact that also requires glove usage, hand rubbing or hand washing should be performed before donning gloves.
- When an indication for hand hygiene follows a contact that has required gloves, hand rubbing or hand washing should occur after removing gloves.
- When an indication for hand hygiene applies while the healthcare worker is wearing gloves, then gloves should be removed to perform hand rubbing or hand washing.
Inappropriate glove use
- The use of gloves when not indicated represents a waste of resources and does not contribute to a reduction of cross-transmission
- It may also result in missed opportunities for hand hygiene
- The use of contaminated gloves caused by inappropriate storage, inappropriate moments and techniques for donning and removing, may also result in germ transmission
As a general policy, selection of non-powdered gloves is recommended since this avoids reactions with the alcohol-based hand rub in use within the healthcare facility.
Re-use/reprocessing
- As medical gloves are single-use items, glove decontamination and reprocessing are not recommended and should be avoided, even if it is common practice in many healthcare settings with low resources and where glove supply is limited.
- At present no standardised, validated and affordable procedure for safe glove reprocessing exists.
Every possible effort should be made to prevent glove reuse in healthcare settings, such as educational activities to reduce inappropriate glove use, purchasing good quality disposable gloves and replenishing stocks in a timely manner.
Healthcare workers should be trained in how to plan and perform procedures according to a rational sequence of events and to use non-touch techniques as much as possible in order to minimize the need for glove use and change.
If the integrity of a glove is compromised (e.g., punctured), it should be changed as soon as possible and complemented with hand hygiene.
Double gloving in countries with a high prevalence of HBV, HCV and HIV for long surgical procedures (>30 minutes), for procedures with contact with large amounts of blood or body fluids, for some high-risk orthopaedic procedures, is considered an appropriate practice.
Use of petroleum-based hand lotions or creams may adversely affect the integrity of latex gloves and some alcohol-based hand rubs may interact with residual powder on healthcare workers’ hands.
Technique for donning and removing non-sterile examination gloves
HOW TO DON GLOVES
1. Take out a glove from its original box
2. Touch only a restricted surface of the glove corresponding to the wrist (at the top edge of the cuff)
3. Don the first glove
4. Take the second glove with the bare hand and touch only a restricted surface of glove corresponding to the wrist
5. To avoid touching the skin of the forearm with the gloves hand, turn the external surface of the glove to be donned on the folded fingers of the gloved hand, thus permitting to glove the second hand
6. Once gloved, hands should not touch anything else that is not defined by indications and conditions for glove use
HOW TO REMOVE GLOVES
1. Pinch one glove at the wrist level to remove it, without touching the skin of the forearm, and peel away from the hand, thus allowing the glove to tum inside out
2. Hold the removed glove in the gloved hand and slide the fingers of the ungloved hand inside between the glove and the wrist. Remove the second glove by rolling it down the hand and fold into the first glove
3. Discard the removed gloves
4. Then, perform hand hygiene by rubbing with an alcohol-based handrub or by washing with soap and water
