Should You Perform Hand Hygiene Before Gloving?

Hand hygiene is one of the most important practices in infection control. In healthcare settings, it helps prevent the transmission of harmful pathogens between patients and healthcare workers. But when it comes to donning gloves, is hand hygiene really necessary before wearing them? Let's explore the reasoning behind this vital practice, especially in light of a recent study published in JAMA Network Open titled Effect of Hand Hygiene Prior to Donning Nonsterile Gloves in Reducing Hand Contamination in Healthcare Settings (Parikh et al., 2023).

The Importance of Hand Hygiene

Proper hand hygiene is essential to infection prevention. Whether you use soap and water or an alcohol-based hand rub, cleaning your hands helps minimize the spread of bacteria and viruses. The World Health Organization (WHO) recommends hand hygiene before and after patient contact, prior to performing aseptic tasks, and after touching potentially contaminated surfaces.

While hand hygiene is crucial, it doesn't end there. The way we handle gloves is just as important.

Gloves and Infection Control

Gloves serve as a barrier to prevent the transfer of pathogens between healthcare workers and patients. However, gloves are not foolproof. They can tear, get punctured, or become contaminated during the process of wearing them. This leads to a critical question: should you perform hand hygiene before wearing gloves?

A study published in JAMA Network Open, titled Effect of Hand Hygiene Prior to Donning Nonsterile Gloves in Reducing Hand Contamination in Healthcare Settings, assessed the value of performing hand hygiene before gloving. The study found that hand hygiene before donning gloves significantly reduced the likelihood of hand contamination, highlighting the importance of this practice in healthcare settings.

Why Perform Hand Hygiene Before Gloving?

There are several reasons why it's essential to clean your hands before putting on gloves:

1. Contamination Risk During Glove Application
While putting on gloves, there's a chance of touching the outside surface, which may be contaminated. If your hands are unclean, you could transfer harmful microorganisms to the gloves. Even though you're wearing gloves, you may still expose yourself or your patients to pathogens. The study in JAMA Network Open emphasized that performing hand hygiene before gloving significantly reduces this risk.

2. Gloves Are Not Perfect
No glove is 100% resistant to contamination. Gloves can have small holes or defects, or they might get contaminated when worn. By cleaning your hands first, you reduce the chance of transferring harmful pathogens onto the glove's surface, ensuring a safer barrier between your hands and the patient.

3. Eliminating Residual Contaminants
Even if gloves seem clean, residual contaminants like bodily fluids or cleaning agents may still be present. Hand hygiene before gloving ensures that your hands are free of any substances that could transfer to the gloves, preventing cross-contamination.

4. Aligning with Infection Control Protocols
Health authorities like the CDC and WHO recommend performing hand hygiene before donning gloves. This practice reduces the risk of healthcare-associated infections (HAIs), keeping both healthcare workers and patients safer.

Guidelines for Hand Hygiene Before Gloving

Here's a simple guide to performing proper hand hygiene before putting on gloves:

Wash or Sanitize Your Hands: Use soap and water or an alcohol-based hand rub (at least 60% alcohol).
Dry Your Hands Thoroughly: Ensure your hands are completely dry before touching gloves.
Put on Gloves Carefully: Avoid touching the outside surface of the gloves with your clean hands.
Check for Glove Defects: Inspect your gloves for any visible tears or holes before use.
Remove Gloves Properly: After your task, take gloves off without touching the outside surface and perform hand hygiene immediately.

Conclusion

Hand hygiene is the first step in preventing infections, and gloves are an important tool in protecting both healthcare workers and patients. While gloves help reduce exposure to harmful microorganisms, they can still be a source of contamination if not used correctly. By performing hand hygiene before gloving, you minimize the risk of cross-contamination and ensure better protection for everyone involved. As the JAMA Network Open study shows, adhering to this practice can significantly reduce hand contamination and improve overall patient safety.

Reference: Parikh, R., Harris, A., Osei, A., et al. (2023). Effect of Hand Hygiene Prior to Donning Nonsterile Gloves in Reducing Hand Contamination in Healthcare Settings. JAMA Network Open.

About the author: Dr. Nirav Pandya, MD (Microbiology), CIC®, is a Clinical Microbiologist and the founder of ICCS, Gujarat's only full-service hospital infection control consultancy. Read more about Dr. Pandya →