Donning gloves before patient contact, with or without prior hand hygiene

Hand hygiene (HH) is a fundamental infection prevention measure in healthcare settings, playing a crucial role in reducing healthcare-associated infections (HAIs). Despite its importance, HH compliance remains suboptimal worldwide. A common error is omitting HH before donning gloves, specifically during WHO Moment 1 ("Before touching a patient"). This study investigates bacterial contamination associated with direct gloving and its potential implications for infection control.

A randomized controlled trial included nurses and doctors preparing to touch patients in the pediatric cardiovascular surgery intensive care unit. Participants were divided into two groups: (1) "HH prior to gloving" (HH performed before donning gloves) and (2) "direct gloving" (no HH before gloves). For each group, 129 samples were collected. Bacterial counts on gloved hands were compared between groups and against bare hands.

The total bacterial colony counts on gloved hands were similar between the HH prior to gloving group and the direct gloving group (p = 0.559). However, bacterial colony counts on gloved hands in both groups were significantly lower compared to bare hands (p = 0.0001, p = 0.0001).

Direct gloving did not increase bacterial contamination on gloves relative to HH before gloving. However, given the established benefits of HH in broader infection control practices, further research is needed to assess the impact of both or separate HH and gloving techniques across different clinical settings.