University of Hertfordshire

From the same journal

  • Sarah Jane Besser
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Original languageEnglish
Pages (from-to)1194-1199
JournalInfection Control and Hospital Epidemiology
Journal publication date1 Dec 2011
Early online date17 Oct 2011
Publication statusPublished - 1 Dec 2011


Background and objective. Wearing of gloves reduces transmission of organisms by healthcare workers’ hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used non-standardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn. Design. Observational study. Participants and setting. Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales. Methods. We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts. Results. Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54–0.79]; ). P < .0001 Conclusion. The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene. Trial registration. National Research Register N0256159318.


Christopher Fuller, Joanne Savage, Sarah Besser, Andrew Hayward, Barry Cookson, Ben Cooper, & Sheldon Stone, '"The dirty hand in the latex glove": A study of hand hygiene compliance when gloves are worn', Infection Control and Hospital Epidemiology, Vol. 32 (12), first published 17 October 2011. The version of record is available online at doi: 10.1086/662619 © 2011 by The Society for Healthcare Epidemiology of America. All rights reserved. Published by the University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America.

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