Service of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland.
National Centre for Infection Control, Swissnoso, Bern, Switzerland.
Swiss Med Wkly. 2022 Feb 7;152:w30110. doi: 10.4414/smw.2022.w30110. eCollection 2022 Jan 31.
This article reviews the available evidence on the effectiveness of gloves in preventing infection during care provided to patients under contact precautions, and analyses the risks and benefits of their systematic use. Although hand hygiene with alcohol-based handrub was shown to be effective in preventing nosocomial infections, many publications put the effectiveness and usefulness of gloves into perspective. Instead, literature and various unpublished experiences point towards reduced hand hygiene compliance and increased risk of spreading pathogens with routine glove use. Therefore, hospitals should emphasise hand hygiene in their healthcare staff and, instead of the routine use of gloves when caring for patients under contact precautions, limit their use to the indications of standard precautions, i.e., mainly for contact with body fluids. Wide and easy access to alcohol-based handrub and continual teaching are essential. If such conditions are met and adherence to hand hygiene is excellent and regularly assessed, the routine use of gloves for patients under contact precautions seems no longer indicated.
本文回顾了在接触预防措施下为患者提供护理时使用手套预防感染的有效性的现有证据,并分析了系统使用手套的风险和收益。虽然含酒精的洗手液手部卫生被证明可以有效预防医院获得性感染,但许多出版物对手套的有效性和实用性进行了分析。相反,文献和各种未发表的经验表明,常规使用手套会降低手部卫生的依从性,并增加传播病原体的风险。因此,医院应强调医护人员的手部卫生,并在接触预防措施下护理患者时,限制手套的使用范围仅限于标准预防措施的指征,即主要用于接触体液。广泛且易于获得含酒精的洗手液以及持续的教育至关重要。如果满足这些条件,并且手部卫生的依从性非常好且定期进行评估,那么接触预防措施下的患者常规使用手套似乎不再有必要。