According to OSHA, the definition of PPE is “specialized clothing or equipment worn by an employee for protection against infectious materials,” but what if the manner of use of that protective equipment could possibly cause the spread of infection?
New research shows that the gloves healthcare workers wear could play a significant role in cross-contamination of pathogens in the healthcare setting. Japanese clinicians presented data to the 2016 American Society for Microbiology Conference that showed the cross-contamination rates of nitrile gloves when they were exposed to bacteria and then came into contact with hospital surfaces. The results were startling. Sae Otani, the author of this study, explained, “This study shows that contaminated gloves increase risks of cross-transmission of healthcare-associated pathogens among healthcare workers and in the environment.”
Similarly, there has been other research demonstrating potential for contamination during PPE removal, putting healthcare workers at risk of infection themselves as well as increasing risk for contact transfer, especially if proper hand hygiene is not performed. In the study, of 435 glove and gown removals, 46% resulted in contamination. However, after an educational intervention of training and feedback, the incidence decreased significantly.
CDC provides guidance on proper doffing of PPE, which includes removing all PPE except a respirator before exiting the patient room, assuming PPE is contaminated after use, and always performing hand hygiene immediately after removing and discarding PPE.
These research findings create a cause for reflection on how PPE relates to hand hygiene compliance. Are they connected? In fact, one hospital sought to find this connection. In a study published in AJIC, a hospital relinquished their rule of mandatory glove use when interacting with patients. After doing so, the hospital exhibited a sustained period of improvement in hand hygiene compliance.
A key takeaway that remains true is that even though we wear protective equipment to help protect against infection, it does not eliminate or reduce the need for proper hand hygiene before donning or after doffing in any way.