How to do it ... infection control
Gloves are close to the cheapest and most effective defense against infections in healthcare settings. But even the best gloves are useless without proper infection control protocols and gloving techniques.
1 - Understanding the risks of not having a glove policy is the first step. An estimated 1.6 to 3.8 million infections with 380,000 deaths are attributed to infections in nursing home residents each year, according to Mary Madison, RN, clinical consultant, Long-Term Care/Senior Care Assisted Living with Briggs Healthcare. A significant percentage of those infections can be avoided with gloves.
Patricia Howell, RN, clinical support manager for McKesson Medical-Surgical, says the most common pathogen transmission route is via hands. Lauren Kappleman, associate product manager, Operating Room/Imaging, AliMed, says nursing homes are more at risk “because the education level in these facilities is lower than the traditional medical market.”
2 - Know your proper level of protection. Madison suggests assessing the availability and placement of gloves on each and every unit.
“Are gloves available in resident living areas? Are they available so that staff can readily use them?” she says. “Repeat this assessment at least annually as well as when the physical setup of a given unit is altered. And encourage staff to report problems like glove sizing and defects.”
Remember, too, that the types and proper uses of gloves vary by setting, says Rosie D. Lyles, M.D., head of clinical affairs for the Clorox Professional Products Company. Also, Howell advises facilities to assess potential gaps by getting frontline staff, along with leadership, to create a performance improvement project as a “very simple and straightforward method for examining the processes for glove usage.”
3 - Choose the right gloves for the right situations. “Using a non-medical glove for a medical task can place the healthcare worker at risk,” says Emily Somers, senior marketing manager for the exam glove division at Medline. That point is lost on some.
“Because it is such a cost-driven market, most facilities go with vinyl gloves as a standard,” AliMed's Kappleman cautions. Most facilities should stock gloves made of varying materials (such as vinyl, nitrile or latex) and protective attributes (such as barrier protection, allergen content, strength and durability, elasticity, fit and comfort, as well as chemical resistance) specific to their intended use.
Howell explains nurses should use ASTM-certified medical gloves because they prevent the spread of bloodborne contamination. Be mindful of the need to stock non-powdered gloves for those employees who have known latex allergies, advises Brian Eichel, environmental services product consultant, HD Supply Healthcare Solutions.
4 - Make compliance a priority. “Without an infection preventionist on staff to train and monitor for compliance of infection control protocols, long-term care facilities could see more potential breaches in proper gloving technique,” Lyles warns. In any case, educate staff on Universal Precautions, and how to properly don, doff and store gloves.
“Make continuing education and regular in-services a priority,” advises Madison.
Avoid storing gloves in nightstands or lab coat pockets. Instruct staff to remove jewelry before donning gloves, Howell advises. Don't hinder glove use by limiting sizes and availability.
“By having multiple locations of glove availability within areas of high glove usage, facilities can help improve usage patterns,” Somers notes. “If a glove isn't fitting correctly, it could be discarded out of frustration.”
Good hand hygiene is the best defense of all against spreading infection. Encourage staff to treat chafed hands. Left untreated, they increase the chance of contracting germs and could discourage glove use because of the irritation, explains Howell.
Mistakes to avoid
Ignoring the need for both medical and non-medical gloves. Housekeeping and food service staff should never be using the same types of gloves as nurses and aides.
Providing poor or inappropriate accessibility and selection. Gloves that aren't applicable or don't fit will discourage staff from wearing them.
Being lulled into a false sense of security. While gloves go far in preventing infection and cross-contamination, there is no substitute for good hand hygiene, including skin care and frequent handwashing.