REALITY OF GLOVE USE AND HANDWASHING IN A COMMUNITY-HOSPITAL

Background: Since the advent of universal precautions and body substan ce isolation, few studies have examined the relationship between glove use and handwashing. Methods: During a 5-month period in 1991, 477 st ructured observations were conducted on 19 patient care units at a com munity teaching hospital during each of three shifts. Patient care con tacts were defined as either high level or low level according to pote ntial for blood or body fluid contact. Results: Health care workers we re potentially exposed to body fluids (high-level contact) on 152 occa sions. Eighty-eight percent of all high-level contacts were limited to the hands; 47% of these contacts occurred during the night shift. Han dwashing occurred after 32% of high-level contacts. Health-care worker s wore gloves in 57% of high-level contacts. Rates of handwashing and glove use varied markedly among patient care units. Correct handwashin g (greater-than-or-equal-to 9 seconds) occurred after 20% of contacts when health care workers wore gloves but after only 3% of high-level c ontacts when gloves were not used (p = 0.004). Conclusions: Despite un iversal precautions or body substance isolation, educational efforts, and written policies, rates of handwashing and glove use are inadequat e in cases of potential blood and body fluid contact. The perceived ne ed for gloves may encourage handwashing.