Hospital staff wearing medical gloves stand in semicircle and stack hands Hospital staff wearing medical gloves stand in semicircle and stack hands

Hand disinfection or gloves? Or both?

Here’s how these two important elements of infection prevention complement each other in everyday healthcare.

Our hands are a major transmission route for pathogens. Bacteria and viruses can survive and multiply on them for up to several hours. This poses a great risk to patients, guests, and employees – especially in medical facilities. To prevent infections, the correct use of medical gloves and hand disinfection is essential. If you look at both measures, the question is clearly not which one to use, but that both of them complement each other and contribute to the successful prevention of infections. As a rule, wearing disposable medical gloves cannot replace hygienic hand disinfection.

Gloves and hand disinfection go hand in hand

Gloves and hand disinfection go hand in hand
In the healthcare sector, protection against nosocomial infections includes hand disinfection and wearing medical gloves. Within the framework of personal protective equipment (PPE), the use of gloves primarily serves to protect staff. It is not sufficient on its own to protect patients from germ transmission and infections if not consistently accompanied by prior and subsequent hand disinfection. Gloves are thus indispensable – but they cannot replace hygienic hand disinfection. This means that hand disinfection and gloves literally go hand in hand when it comes to infection prevention.
A medical glove rises from a glove box

When is it mandatory to wear gloves?

Indications for wearing medical gloves

There are mandatory requirements for the use of medical gloves. Gloves must be worn during the following activities:

  1. In contact with body excreta
  2. During aseptic activities
  3. During possible contact with infectious material
  4. During invasive procedures and operations

When using gloves, the following guidelines apply:

  • Gloves must only be put on dry hands
  • Gloves must be removed or replaced if they are damaged or contaminated, or after the end of the care activity
Disinfectant drips from a blue pump bottle into a hand

When do hands need to be disinfected?

Indications for hygienic hand disinfection

In addition to the use of gloves, another measure of infection prevention is hygienic hand disinfection. As a guide for nursing staff, the World Health Organization (WHO) advocates 5 Moments for hand hygiene:

  1. BEFORE patient contact
  2. BEFORE aseptic activities
  3. AFTER contact with potentially infectious materials or body fluids
  4. AFTER patient contact
  5. AFTER contact with surfaces in the direct patient environment

In addition, hand disinfection should be carried out when gloves are used in the following situations:

  1. BEFORE removing gloves from the glove box
  2. AFTER taking off the gloves
The 5 Moments for Hand Hygiene of the World Health Organization (WHO)
The 5 Moments for Hand Hygiene of the World Health Organization (WHO)

Good to know in the context of the 5 Moments:

  • After "initial contact", further hand disinfection may be required on the same patient e.g., when changing from an unclean to a clean side.
  • Before aseptic activities, hand disinfection alone can significantly reduce the most common nosocomial infections (including ventilator-associated pneumonia, urinary tract infections from catheters, postoperative wound infections, and bloodstream infections from central venous catheters).
  • Gloves provide indispensable, but not solely sufficient protection against infection. Always disinfect hands after removing gloves.
  • Disinfect hands after every procedure on the patient and before contact with objects outside the patient environment, e.g. the ward round trolley.
  • Disinfect hands even if there is only contact with the patient environment, e.g., when exchanging glasses and water bottles on the bedside table.
More information on choosing a high-quality disinfectant is available here.

Source:
KRINKO (2016). Händehygiene in Einrichtungen des Gesundheitswesens, Bundesgesundheitsbl. 59: 1189-1220.
https://www.rki.de/DE/Content/Infekt/Krankenhaushygiene/Kommission/Downloads/Haendehyg_Rili.pdf?__blob=publicationFile (accessed 21.07.2021)

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