THE PROPER AND IMPROPER USE OF GLOVES
Glove use is essential in acute care facilities, skilled nursing, long term care or any environment where there is a need to maintain a barrier from one person, place or thing to another person, place or thing. We know glove use is the mainstay of Standard Precautions (Standard Precautions First)
As often as we observe the correct use of gloves, there’s the real probability we are witness to the opposite. The use of gloves during Phlebotomy procedures comes to mind.
- The phlebotomist puts on a pair of non-sterile gloves, places the tourniquet, prepares the syringe, runs an alcohol wipe over the anticubital fossa, then palpates the vein with the gloved finger after the alcohol wipe and before inserting the needle into the now re-contaminated skin. Well in any case, that quick dab with an alcohol wipe wasn’t really going to do the job anyway. But it was something. My guess is the phlebotomist is attempting to protect themselves from the patient’s blood and body fluids (and that’s appropriate) but they aren’t considering protecting the patient from the act of the procedure or the environment. But they had on gloves.
- During a dressing change. The nurse dons’ non-sterile gloves to remove the old dressing and then removes them. Once ready to clean the wound and apply sterile dressings, the nurse dons’ sterile gloves but doesn’t wash her hands first. Unwashed hands and sterile gloves isn’t good practice, why? Washing hands, when done well, removes most of the bacteria/pathogens found on our hands. Good handwashing practices are really the best preventative measures we can take to prevent cross contamination. If there is a microscopic tear or hole in the gloves, the bacteria escape in to the wound, introducing the nurse’s bacteria to the patient’s wound. But she had on gloves.
- Food preparation in the kitchen. Not only do we see this in hospital kitchens, but this can be observed in any deli section of your favorite grocery store or restaurant, as well. The employee dons’ non-sterile gloves in anticipation of food preparation, then goes about touching any and all items in the environment before returning to finish preparing the sandwich, the salad or the arranging of fruit or garnishes on the plate. But they had on gloves.
- At the grocery deli counter. An unaware employee might be seen wiping gloved hands on their apron, going to the cash register and handling money, or returning the bundles of meat or cheese to their rightful place, before handling the last slice of meat or cheese, wrapping it up and handing it to the customer. But they had on gloves.
To be fair, gloves can be confusing to many employees and for good reason. In many cases they give one a false sense of security; the person may honestly believe they are doing the right thing by placing them on their hands, but they haven’t been educated properly or frequently enough to their best use. Do they understand how, why, where and when they should be using gloves? If not, they are of no use at all.
This is a great visual for glove use; it can be printed and used as a guide:
Courtesy of APIC.ORG