Richard Wells Research Unit, University of West London, London, UK.
Infection Prevention & Control Department, Imperial College Healthcare NHS Trust, London, UK.
J Hosp Infect. 2014 Feb;86(2):110-6. doi: 10.1016/j.jhin.2013.11.003. Epub 2013 Nov 28.
The incorrect use of clinical gloves and the failure to change them between procedures increases the risk of cross-transmission. Much attention has been focused on compliance with hand hygiene.
To investigate the use of gloves, their potential for cross-contamination, and factors that influence the decision of healthcare workers (HCWs) to wear them.
The use of gloves was observed in six wards in a single UK hospital trust. Risk of cross-contamination was defined as a violation of a 'moment of hand hygiene' during the glove-use episode. Twenty-five HCWs from the wards included in the observational audit were interviewed to identify the drivers for glove use.
A total of 163 glove-use episodes were observed over a period of 13 h. Glove use was inappropriate in 69 out of 163 (42%) episodes, with gloves commonly used inappropriately for low-risk procedures (34/37; 92%). In 60 out of 163 (37%) episodes of glove use there was a risk of cross-contamination, most (48%) being associated with failure to remove gloves or with performing hand hygiene after use. HCW interviews indicated that the decision to wear gloves was influenced by both socialization and emotion. Key emotions were disgust and fear. Assumptions that patients preferred gloves to be used, confusion about when to wear them, and social norms and peer pressure were also important influences.
Glove use is associated with risk of cross-contamination and should be more explicitly integrated into hand hygiene policy. An understanding of the drivers of glove-use behaviour is required to design interventions to reduce misuse and overuse.
临床手套使用不当且在操作之间未更换会增加交叉传播的风险。目前人们已经高度关注手卫生的依从性。
调查手套使用情况、潜在的交叉污染以及影响医护人员（HCW）戴手套决策的因素。
在英国某单一医院信托的六个病房中观察手套使用情况。将“手卫生时刻”受到违反的情况定义为手套使用过程中的交叉污染风险。对纳入观察性审计的 25 名病房 HCW 进行访谈，以确定戴手套的驱动因素。
在 13 小时的时间内观察到 163 次手套使用事件。在 163 次手套使用事件中，有 69 次（42%）使用不当，其中常见于低风险操作（34/37；92%）。在 163 次手套使用事件中有 60 次（37%）存在交叉污染风险，其中大多数（48%）与未摘手套或使用后未进行手卫生有关。HCW 访谈表明，戴手套的决定受到社会化和情绪的影响。关键情绪是厌恶和恐惧。认为患者更喜欢戴手套、对手套使用时机的困惑、社会规范和同伴压力也是重要的影响因素。
手套使用与交叉污染风险相关，应更明确地将其纳入手卫生政策。需要了解戴手套行为的驱动因素，以设计减少误用和过度使用的干预措施。
