11.16.2011: Are doctors’ gloves germ factories?

November 9, 2011
Globe and Mail Blog

Health-care workers wearing gloves found to be less stringent about hand hygiene

Few things seem as sterile as a doctor’s disposable gloves. But don’t be fooled.

There’s a good chance those latex gloves are crawling with germs, The New York Times reports [http://well.blogs.nytimes.com/2011/11/08/gloves-are-no-guarantee-your-doctors-hands-are-clean].

The reason is that health care workers who don gloves are less stringent about hand hygiene, according to The Dirty Hand in the Latex Glove, a study published [http://www.jstor.org/pss/10.1086/662619]in the journal Infection Control and Hospital Epidemiology.

Germs can travel through latex, the most common material used in medical gloves. And when medical practitioners pull off the stretchy material, contaminated droplets can “back spray” onto their hands.

“If you’re a patient, you assume that if someone is wearing gloves they’re being careful and protecting you from infection,” said the study’s lead author, Sheldon Stone, a senior lecturer in the department of medicine at the Royal Free Campus of University College London Medical School.

“But in fact, their hands could be very dirty.”

In the study, doctors and nurses wore gloves in about one-quarter of all patient interactions. In 60 per cent of those cases, they did not wash up either before or after contact with the patient.

The researchers found that when gloves were used, the handwashing rate in the 15 British hospitals studied was 41 per cent. That’s about the same as the compliance rate [http://www.infectioncontroltoday.com/articles/2011/06/strategies-to-boost-hand-hygiene-compliance.aspx]for handwashing in U.S. hospitals – about 40 per cent – except that doctors and nurses are most likely to use gloves when dealing with bodily fluids and highly infectious illnesses.

“In the patient group or the clinical situation where you’re more likely to pick up potentially spreadable germs, health-care workers are actually less likely to clean their hands afterward,” Dr. Stone said.

Hospitals have gone to extreme measures to get doctors to wash their hands. At the Los Angeles-based Cedars-Sinai Medical Center, “hand hygiene posses [http://www.nationalreviewofmedicine.com/issue/2007/10_30/4_patients_practice03_18.html]” didn’t achieve high compliance rates until they bribed doctors with Starbucks gift cards and suspended a physician for having dirty hands.

In most hospitals, poor hand hygiene remains rampant, Dr. Stone told The New York Times. “It’s gross.”

He and his colleagues surmised that health-care workers wrongly assume that gloves are germ-proof. But in reality, latex gloves are only as clean as the hands inside.

Do you assume that a doctor’s gloves are clean? How would you go about asking a health care worker to wash up before treating you?

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