4
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Continued wearing of gloves: a risk behaviour in patient care

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          Background

          The wearing of gloves is included in the standard principles for preventing healthcare associated infections. A continued wearing of gloves may, however, result in the transmission of organisms instead of preventing infections. Few studies have explored how common it is for surfaces to be touched by potentially contaminated gloves.

          Methods

          Secondary analysis of field notes from 48 hours of unstructured observations of healthcare personnel's actions during patient care. The new focus was on to what extent healthcare personnel wore gloves that should have been removed or changed, what surfaces were touched by contaminated gloves and what patient-related activities were involved.

          Results

          A continued wearing of gloves occurred in about half of the observed episodes of patient care. On average, 3.3 surfaces were touched by contaminated gloves. The surfaces most frequently touched were ‘unused single-use items’, ‘equipment controls/switches/regulators/flush buttons’ and ‘bed linen’. This occurred mostly while helping patients with ‘personal hygiene’, when performing ‘test taking’ or during procedures involving the operation of medical or other ‘equipment’.

          Conclusion

          The continued wearing of gloves during patient-related activities carries the risk of organism transmission, as the gloves touch many surfaces. The most critical moments seem to be when the use of gloves is considered essential. A better understanding of the motivators of improper glove-use behaviour is needed to develop interventions that rectify the improper use of gloves.

          Related collections

          Most cited references27

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Interrater reliability: the kappa statistic

          The kappa statistic is frequently used to test interrater reliability. The importance of rater reliability lies in the fact that it represents the extent to which the data collected in the study are correct representations of the variables measured. Measurement of the extent to which data collectors (raters) assign the same score to the same variable is called interrater reliability. While there have been a variety of methods to measure interrater reliability, traditionally it was measured as percent agreement, calculated as the number of agreement scores divided by the total number of scores. In 1960, Jacob Cohen critiqued use of percent agreement due to its inability to account for chance agreement. He introduced the Cohen’s kappa, developed to account for the possibility that raters actually guess on at least some variables due to uncertainty. Like most correlation statistics, the kappa can range from −1 to +1. While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations. Judgments about what level of kappa should be acceptable for health research are questioned. Cohen’s suggested interpretation may be too lenient for health related studies because it implies that a score as low as 0.41 might be acceptable. Kappa and percent agreement are compared, and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            'My five moments for hand hygiene': a user-centred design approach to understand, train, monitor and report hand hygiene.

            Hand hygiene is a core element of patient safety for the prevention of healthcare-associated infections and the spread of antimicrobial resistance. Its promotion represents a challenge that requires a multi-modal strategy using a clear, robust and simple conceptual framework. The World Health Organization First Global Patient Safety Challenge 'Clean Care is Safer Care' has expanded educational and promotional tools developed initially for the Swiss national hand hygiene campaign for worldwide use. Development methodology involved a user-centred design approach incorporating strategies of human factors engineering, cognitive behaviour science and elements of social marketing, followed by an iterative prototype test phase within the target population. This research resulted in a concept called 'My five moments for hand hygiene'. It describes the fundamental reference points for healthcare workers (HCWs) in a time-space framework and designates the moments when hand hygiene is required to effectively interrupt microbial transmission during the care sequence. The concept applies to a wide range of patient care activities and healthcare settings. It proposes a unified vision for trainers, observers and HCWs that should facilitate education, minimize inter-individual variation and resource use, and increase adherence. 'My five moments for hand hygiene' bridges the gap between scientific evidence and daily health practice and provides a solid basis to understand, teach, monitor and report hand hygiene practices.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Systematic review of studies on compliance with hand hygiene guidelines in hospital care.

              To assess the prevalence and correlates of compliance and noncompliance with hand hygiene guidelines in hospital care. A systematic review of studies published before January 1, 2009, on observed or self-reported compliance rates. Articles on empirical studies written in English and conducted on general patient populations in industrialized countries were included. The results were grouped by type of healthcare worker before and after patient contact. Correlates contributing to compliance were grouped and listed. We included 96 empirical studies, the majority (n = 65) in intensive care units. In general, the study methods were not very robust and often ill reported. We found an overall median compliance rate of 40%. Unadjusted compliance rates were lower in intensive care units (30%-40%) than in other settings (50%-60%), lower among physicians (32%) than among nurses (48%), and before (21%) rather than after (47%) patient contact. The majority of the time, the situations that were associated with a lower compliance rate were those with a high activity level and/or those in which a physician was involved. The majority of the time, the situations that were associated with a higher compliance rate were those having to do with dirty tasks, the introduction of alcohol-based hand rub or gel, performance feedback, and accessibility of materials. A minority of studies (n = 12) have investigated the behavioral determinants of hand hygiene, of which only 7 report the use of a theoretical framework with inconclusive results. Noncompliance with hand hygiene guidelines is a universal problem, which calls for standardized measures for research and monitoring. Theoretical models from the behavioral sciences should be used internationally and should be adapted to better explain the complexities of hand hygiene.
                Bookmark

                Author and article information

                Contributors
                Journal
                Infect Prev Pract
                Infect Prev Pract
                Infection Prevention in Practice
                Elsevier
                2590-0889
                17 September 2020
                December 2020
                17 September 2020
                : 2
                : 4
                : 100091
                Affiliations
                [a ]Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Sweden
                [b ]Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
                [c ]Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden
                Author notes
                []Corresponding author. Address: Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, SE 801 76, Gävle, Sweden. Phone: +46 26 64 84 48. magnus.lindberg@ 123456hig.se
                Article
                S2590-0889(20)30055-X 100091
                10.1016/j.infpip.2020.100091
                8336026
                34368725
                c3aa91d1-4026-477b-818b-96ccfc56f09e
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 25 June 2020
                : 10 September 2020
                Categories
                Original Research Article

                gloves,infection prevention,nurse assistants,organism transmission,registered nurses

                Comments

                Comment on this article