Providing care to patients in contact isolation: is the systematic use of gloves still indicated?

Abstract

This article reviews the available evidence on the effectiveness of gloves in preventing infection during care provided to patients under contact precautions, and analyses the risks and benefits of their systematic use. Although hand hygiene with alcohol-based handrub was shown to be effective in preventing nosocomial infections, many publications put the effectiveness and usefulness of gloves into perspective. Instead, literature and various unpublished experiences point towards reduced hand hygiene compliance and increased risk of spreading pathogens with routine glove use. Therefore, hospitals should emphasise hand hygiene in their healthcare staff and, instead of the routine use of gloves when caring for patients under contact precautions, limit their use to the indications of standard precautions, i.e., mainly for contact with body fluids. Wide and easy access to alcohol-based handrub and continual teaching are essential. If such conditions are met and adherence to hand hygiene is excellent and regularly assessed, the routine use of gloves for patients under contact precautions seems no longer indicated.

Transmission of Carbapenem-Resistant Enterobacterales in an Overcrowded Emergency Department: Controlling the Spread to the Hospital

“…We hypothesize that given the high number of patients under CP, the healthcare workers adhered less to HH. This is a phenomenon previously observed by different authors [ 15 ].…”

Hand hygiene compliance in a Brazilian COVID-19 unit: the impact of moments and contact precautions

“…However, glove use does not replace HH [ 7 , 9 ]. Studies of healthcare professionals’ HH complicance when caring for patients in contact precautions have demonstrated that glove use is associated with both decreased HH and an increased risk of pathogen transmission [ 5 , 23 ]. We found that inappropriate glove use was associated with lower HH compliance in our COVID-19 ICU, which is similar to the results of prior studies [ 9 , 15 ].…”

Prevalence of Acinetobacter baumannii with multiple drug resistance isolated from patients with ventilator-associated pneumonia from 2010 to 2020 in the world: a systematic review and meta-analysis

“…Patients admitted to the ICU wards of hospitals are most susceptible to receiving nosocomial pneumonia due to A. baumannii [67]. Strict instructions to prevent the spread of A. baumannii infection in hospital settings emphasize that hospital staff and treatment team should wash their hands immediately after removing their gloves and at contact intervals with each patient, they should also remove hand contamination before and after contact with patients [67][68][69]. These guidelines are emphasized since most cases of nosocomial infections are transmitted through contact.…”