Infection control in healthcare relies on creating barriers to prevent the transfer of infectious agents. Gloves represent a physical barrier that protects both the person wearing them and the person they are assisting from potential exposure to microorganisms. Understanding the correct application of these barriers requires precise language when discussing established safety guidelines. The question of whether wearing gloves is a universal precaution touches on the historical evolution of these safety practices.
Understanding Standard Precautions
The term “Universal Precautions” is outdated, replaced by the more comprehensive “Standard Precautions” in the mid-1990s. Universal Precautions were introduced to address the risk of bloodborne pathogens (like HIV and Hepatitis B) by treating all blood and certain body fluids as potentially infectious. The Centers for Disease Control and Prevention (CDC) expanded this concept to create Standard Precautions, which apply to all patient care, regardless of a patient’s known or suspected infection status.
Standard Precautions represent the minimum infection prevention practices used for every patient encounter. These practices recognize that all body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents. The core components of Standard Precautions extend beyond the use of gloves and other personal protective equipment (PPE).
Standard Precautions include several key practices:
- Diligent hand hygiene.
- Safe injection practices and sharps safety protocols.
- Respiratory hygiene and cough etiquette, such as covering the mouth and nose when coughing or sneezing.
- Proper handling of soiled patient-care equipment.
- Cleaning and disinfection of environmental surfaces.
Gloves as a Component of Protection
Gloves are a component of Standard Precautions, worn whenever contact with specific materials is anticipated. Their function is to create a physical separation between the wearer’s hands and potential hazards, such as blood, body fluid, mucous membranes, or non-intact skin. This barrier reduces the risk of the wearer becoming contaminated and prevents the transfer of microorganisms from the wearer’s hands to the patient.
The decision to wear gloves is based on a risk assessment for the specific task, not a blanket requirement for all patient contact. Gloves are required for tasks like drawing blood, assisting with procedures where splashes of body fluids may occur, or handling contaminated equipment. Non-sterile examination gloves are the standard for most patient care activities under Standard Precautions.
Sterile gloves are reserved for surgical or other invasive procedures that require maintaining a sterile field. Improper glove use, such as wearing them unnecessarily, can give a false sense of security and may lead to neglecting proper hand hygiene. Gloves do not shield against needle sticks or other sharp injuries, emphasizing the need for comprehensive safety protocols.
Protocols for Safe and Effective Glove Use
The effectiveness of gloves depends on the technique used for putting them on (donning) and taking them off (doffing). Proper donning begins with performing hand hygiene, ensuring hands are clean before the barrier is applied. The gloves should be the correct size to prevent tears or impaired dexterity, and they are typically pulled over the cuff of a gown if a gown is also being worn.
Doffing is a critical step to prevent cross-contamination, as the outer surface of the glove is considered contaminated. The recommended technique involves grasping the outer edge of one glove near the wrist and peeling it away, turning it inside out as it is removed. This first glove is then held in the remaining gloved hand.
The second glove is removed by sliding an ungloved finger under the cuff and peeling it off from the inside, creating a bag that contains both gloves with the contaminated surfaces on the inside. Immediately after the gloves are removed and discarded, hand hygiene must be performed again to eliminate any organisms that may have transferred during the doffing process. Wearing the same pair of gloves for different tasks or between different patients is strictly prohibited because it directly facilitates the transfer of microorganisms.