Exploring inappropriate certified nursing assistant glove use in long-term care

Area of Science:

• Healthcare-associated infections
• Infection control
• Patient safety

Background:

• Certified Nursing Assistants (CNAs) commonly use gloves during patient care under standard precautions.
• Inappropriate glove use by CNAs can facilitate pathogen transmission to patients and the environment, increasing the risk of health care-associated infections (HAIs).

Purpose of the Study:

• To examine the extent of improper glove usage among CNAs during specific patient care activities.
• To identify potential breaches in glove use protocols that could contribute to pathogen spread.

Main Methods:

• A descriptive, structured observational study was conducted.
• 74 CNAs in a long-term care facility were observed during toileting and perineal care procedures.
• Data on glove use, glove changes, and touch points were systematically recorded.

Main Results:

• CNAs demonstrated frequent inappropriate glove use, failing to change gloves at 66.4% of indicated points.
• Over 44% of gloved touch points were contaminated, with a median of 8.0 contaminated touches per patient care event.
• Most observed patient care events (82.4%) involved more than one contaminated touch point, all with gloved hands.

Conclusions:

• Observed inappropriate glove use among CNAs is a significant concern.
• Contaminated gloves likely contribute to pathogen cross-contamination within healthcare settings.
• Further research is needed to develop and evaluate strategies for enhancing CNA glove use to mitigate HAIs.