Hand Hygiene and Gloves: Infection Control is Within Your Grasp*
by Deborah Davis, MS, MBA

Promotion of hand hygiene and the appropriate use of gloves are major challenges for infection control professionals. Today, nosocomial infections affect more than 2 million patients annually in the U.S. at a cost of more than $4.5 billion. Hand hygiene is the simplest, most effective measure for preventing nosocomial infection, yet it is often difficult to achieve compliance.

Health-care workers report various reasons for not adhering to hand hygiene recommendations:

	Interference with patient care
	Forgetfulness
	Lack of scientific evidence of impact
	Disagreement with guidelines
	Insufficient time
	High workload and understaffing
	The belief that wearing gloves obviates the need for proper hand washing

The CDC's Hospital Infection Control Practices Advisory Committee (CDC-HICPAC) recommends the use of gloves, gowns and hand washing to prevent person-to-person transmission of VRE (vancomycin-resistant enterococci). Failure to remove gloves after patient contact or between dirty and clean body site care for the same patient is considered to be noncompliant with hand hygiene recommendations.

By establishing a protocol and undertaking a consistent, effective hand-care regimen, health-care workers can maintain the integrity of their skin against blood-borne pathogens and other infectious material. A hand-care protocol should address hand washing, use of lotions/moisturizers, and appropriate glove usage. Studies suggest that daily reminders and information about patient infections can positively influence performance, as can the use of role models to influence behavior and demonstrate management support for a culture of worker and patient safety.

*Article published in Infection Control Today, Vol. 5 No. 7, July 2001.