Hand hygiene compliance in a universal gloving setting.

Area of Science:

• Infection Prevention and Control
• Healthcare Epidemiology
• Patient Safety

Background:

• Universal gloving is proposed as an infection control strategy, but its effectiveness is limited by challenges in proper glove use and hand hygiene.
• Organisms can persist on gloves if not changed correctly, and adherence to hand hygiene protocols before and after glove use is crucial.
• Limited data exist on glove changing practices and hand hygiene compliance within universal gloving protocols.

Purpose of the Study:

• To evaluate the impact of education and feedback on hand hygiene compliance in a universal gloving setting.
• To assess changes in glove use compliance and the incidence of methicillin-resistant Staphylococcus aureus (MRSA).

Main Methods:

• A nonrandomized observational before-after study was conducted in a 10-bed intensive care unit.
• Direct observation of hand hygiene and glove use compliance was performed.
• Interventions included education and feedback on hand hygiene practices.

Main Results:

• Hand hygiene compliance significantly increased from 16.1% to 56.8% over five study periods.
• Variations in baseline compliance, improvement, and noncompliance reasons were noted across different indications.
• Compliance with universal gloving decreased, while the incidence of MRSA also declined.

Conclusions:

• Implementing proper glove use and hand hygiene concurrently in a universal gloving setting is complex.
• Direct observation combined with targeted education and feedback can effectively enhance compliance with hand hygiene protocols.