Patient safety is paramount in healthcare, and maintaining a sterile environment is a crucial aspect of preventing healthcare-associated infections. A recent study published in the Journal of the American Medical Association (JAMA) Network challenges traditional practices, suggesting that a “direct-gloving” strategy may not only be safe but also enhance adherence to infection prevention practices, ultimately contributing to improved patient safety.
For years, guidelines have emphasized the necessity of hand hygiene before donning nonsterile gloves in medical settings. However, a study involving 3,790 healthcare personnel across 13 hospital units found that adherence to this practice was only 41% (Baloh et al., 2019). High workload, insufficient time, and understaffing were identified as significant barriers preventing healthcare personnel from consistently following hand hygiene guidelines.
In contrast, an impressive 87% of participants adhered to the “direct-gloving” strategy, challenging the status quo. In this approach, nonsterile gloves were worn without preceding hand hygiene. Participants noted several perceived benefits, with 68% recognizing potential advantages such as increased efficiency, cost savings, reduced skin irritation, improved adherence to expectations, and enhanced staff satisfaction.
Addressing safety concerns, the study cited a previous trial demonstrating no significant difference in total bacterial colony counts between the direct-gloving strategy and the conventional method of hand hygiene before glove use. Both approaches exhibited a low overall prevalence of potential pathogenic organisms on gloves. While the CDC still supports the traditional hand hygiene method, this study and studies conducted in the future may someday have an impact on their stance.
In the pursuit of maintaining a sterile environment and prioritizing patient safety, healthcare facilities are constantly seeking ways to optimize infection prevention practices. This study aligns with the mission of Sterile Aware, emphasizing the need for practices that not only meet guidelines but also enhance overall patient safety.
It is important to note that while the direct-gloving strategy showcased remarkable results across various healthcare units, the study highlighted challenges in emergency departments. Adherence rates to both hand hygiene and glove use were found to be the lowest in these settings. The study suggests that caution should be exercised in adopting the direct-gloving approach in emergency departments or areas with low overall adherence until further research is conducted.
In conclusion, the direct-gloving strategy presents a promising alternative that aligns with the principles of Sterile Aware. By addressing barriers to hand hygiene and providing a feasible solution for healthcare personnel, this approach has the potential to significantly enhance adherence to infection prevention practices. As the healthcare landscape continues to evolve, embracing innovative strategies that prioritize patient safety is paramount. The Sterile Aware community can lead the way by fostering a culture of continuous improvement and staying informed about research that challenges existing norms for the betterment of patient care. In the journey towards a safer healthcare environment, exploring alternatives like the direct-gloving strategy is a step forward, contributing not only to the well-being of patients but also to the overall success of Sterile Aware practices in healthcare settings.
References:
Baloh J, Thom KA, Perencevich E, Rock C, Robinson G, Ward M, Herwaldt L, Reisinger HS. Hand hygiene before donning nonsterile gloves: Healthcare workers’ beliefs and practices. Am J Infect Control. 2019 May;47(5):492-497. doi: 10.1016/j.ajic.2018.11.015. Epub 2019 Jan 5. PMID: 30616932; PMCID: PMC6785986.
Martonicz, T. W. (2023, November 22). Direct gloving vs hand hygiene before donning gloves: A hospital infection control study. Infection Control Today. https://www.infectioncontroltoday.com/view/direct-gloving-vs-hand-hygiene-before-donning-gloves-hospital-infection-control-study
Study finds hand washing before gloving hinders adherence. Cleaning & Maintenance Management. (2023, October 27). https://cmmonline.com/news/study-finds-hand-washing-before-gloving-hinders-adherence
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