Thursday, November 7, 2013

Is hand hygiene prior to nonsterile gloving really necessary?

There's a new study in American Journal of Infection Control that I think is really important. The University of Maryland group performed a randomized controlled trial to evaluate the impact of hand hygiene prior to donning nonsterile gloves. The study involved 230 healthcare workers in 7 ICUs who were randomized to either perform hand hygiene with an alcohol-based handrub or perform no hand hygiene, prior to donning nonsterile gloves for contact precautions. Hands were cultured prior to randomization and after donning of gloves.

The key findings were as follows:
  • There was no difference in baseline hand contamination between the 2 groups
  • There was no difference in contamination of the gloved hand between the 2 groups
  • A pathogen was detected on only 3 hands (1 MRSA in the hand hygiene group, and 2 MSSA in the no hand hygiene group)
  • Importantly, hand hygiene prior to gloving added 31.5 secs to the gloving process. For the average ICU nurse caring for a patient in contact precautions, this adds up to 19 extra minutes per 12-hour shift.
Bottom line:  this study suggests that hand hygiene prior to gloving is a nonvalue-added activity.

Photo:  The Sound of Science

3 comments:

  1. So Mike, are you saying we can use gloves now? Just having some fun. Interesting results, although a very small (underpowered) single center study. Worth repeating at multiple sites and in multiple settings probably before drawing any conclusions.

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  2. One problem with this - if you don't wash your hands before accessing the glove box you end up with dirty gloves. Dirty hands = dirty gloves.

    At our site we pulled gloves out of hundreds of open, in use glove boxes and found just about every pathogen you could think of. Control boxes (unopened) were positive for only non pathogenic, environment bacteria.

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