Background
Health care workers (HCWs) are recommended to wear nonsterile clinical gloves (NSCG)
for direct contact with blood and body fluids. However, there is evidence of extensive
inappropriate NSCG use.
Methods
A mixed-methods study comprising observation of NSCG use in 2 acute hospitals and
semistructured HCW interviews. Qualitative data were categorized using thematic analysis.
Findings were mapped to the Systems Engineering Initiative for Patient Safety model
and used to develop a strategy for improving NSCG use.
Results
Two hundred seventy-eight procedures performed in 178 episodes of care involved the
use of NSCG. NSCG were inappropriate for 59% of procedures (165 out of 278). Risk
of cross-contamination occurred in 49% (87 out of 178) episodes. Twenty-six HCWs were
interviewed; emotion and socialization were key factors influencing decisions to use
NSCG. Data from observation and thematic analysis were mapped to 6 interacting components
of the Systems Engineering Initiative for Patient Safety work system. Interventions
targeting each component informed quality improvement strategies
Conclusions
Despite intense promotion of hand hygiene as the key measure to protect patients from
health care-associated infection, NSCG dominate routine clinical practice and potential
cross-contamination occurs in 50% of care episodes. Such practice is associated with
significant environmental and financial costs and adversely affects patient safety.
The application of human factors and ergonomics to the complex drivers of inappropriate
NSCG behavior may be more effective than conventional approaches of education and
policy in achieving the goal of preventing health care-associated infection and improving
patient safety.
Key Words
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Article Info
Publication History
Published online: March 29, 2017
Footnotes
The study was funded by a small collaborative grant from the Infection Prevention Society .
Conflicts of interest: None.
Identification
Copyright
© 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
