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s a nurse consultant, I am frequently asked by extended care facilities to observe daily practices. I often notice improper glove use by both licensed and unlicensed staff members. Common infractions include overuse of gloves in situations where exposure to blood or body fluids is not expected, vinyl gloves used to deal with blood spillages, and gloves not removed when indicated (thus contaminating the surrounding environment). Researchers have documented similar findings.¹ In 1 long-term care facility, gloves were worn in 139 of 170 interactions when indicated but changed appropriately in only 1 of 132 interactions. Due to inappropriate glove use and lack of proper handwashing, researchers concluded that germs could have potentially been spread in 158 of 193 interactions—a staggering 82%. This article will describe the types of gloves available on the market, fitting the glove to the job, and when gloves should be worn and removed.

Successful Glove Selection

       One glove does not fit all tasks or departments. During the process of glove selection, ask for input from staff members of various departments.

Table 1

Each department should evaluate the performance in its respective areas for the following: proper fit, comfort, resistance to tearing and leaking, tactile sensitivity, ability to perform job tasks and hold objects without dropping them, and performance data from the manufacturer. Table 1 illustrates the types of nonsterile gloves available and the pros and cons of each.

When to Wear and Remove Gloves

       More troubling and threatening than inappropriate glove selection or glove failure is the spread of germs by inappropriate glove use. A glove-use study found that almost half of the gloves worn by a group of nurses became contaminated with methicillin-resistant Staphylococcus aureus (MRSA) when the nurses touched not the patients themselves but various surfaces in the patients’ rooms; in fact, MRSA has been known to survive on the outer surfaces of packaged sterile supplies for more than 38 weeks.²
       Healthcare professionals have a fundamental responsibility to adopt good infection control practices when wearing gloves. Gloves should be donned just prior to contact with mucous membranes, nonintact skin, or any moist body substance. Donning gloves too early exposes the resident to microorganisms residing on room surfaces (eg, bedrails, bed linens, drawer pulls, etc.). To avoid this, direct caregivers must be in the habit of assembling all supplies needed for care before providing care to minimize touching environmental surfaces. If the direct care provider needs to retrieve items that have not been gathered, the contaminated gloves should first be removed.³
       Gloves should be changed when personnel deliver care at a specific body site and then must move to another body site on the same resident for more care. For example, when cleaning around a Foley catheter, then changing a wound dressing, both tasks require gloves to be worn; however, the gloves should be removed after Foley care. Hands should be washed, then a fresh pair of gloves should be donned for the dressing change. If the direct caregiver does not change gloves appropriately, a cross contamination of germs from 1 body site to another body side can occur.¹³
       Once care is completed, the contaminated gloves should be removed before adjusting the resident’s clothing or bed linens, placing side rails in an up position, or opening privacy curtains. Failure to do so taints the environment and exposes staff members, visitors, and others to the resident’s germs. Of course, glove use does not replace washing of one’s hands, which should occur regardless of glove use.³

Conclusion

       With information to evaluate each glove type, it is important to determine whether your facility is using the best glove to get the job done. To assure gloves are worn and removed at appropriate times and handwashing occurs, make random observations of daily staff practices. By taking these proactive strategies, you can get a handle on your facility’s glove use.