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Comments Regarding Masroor et al: Perceptions and Barriers to Universal Gloving for Infection Prevention

Published online by Cambridge University Press:  28 January 2016

Richard Pougnet*
Affiliation:
Teaching Hospital, Environmental Diseases Center, Brest, France EA 4686, Medical Ethics (Ethique, Professionnalisme et Santé), European University of Britany, Brest, France
Laurence Pougnet
Affiliation:
Infection Control Team, Military Hospital Clermont-Tonnerre, Brest, France
Ronan Garlantézec
Affiliation:
Public Health, European Universitary of Brittany, Rennes, France.
*
Address correspondence to Richard Pougnet, MD, 10 rue des onze martyrs, 29200 Brest France (richard.pougnet@live.fr).
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Abstract

Type
Letters to the Editor
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

To the Editor—Masroor et alReference Masroor, Donovan, Sanogo, Couture, Ober, Stevens and Bearman 1 reported an additional way to investigate the gloving rate: perceptions of healthcare workers (HCWs) and their interaction with the perception of patients. The authors were right to seek responses from every HCW, considering that other studies have shown that gloving is determined by the behavior of all HCWs.Reference Turco, Chalaye, Poulard, Gocko, Neyron, Courbon and Berthelot 2 The results reported by Masroor et al showed that HCWs were ambivalent: On the one hand, they knew that gloving reduces cross transmission risk; on the other hand, they considered gloving an inconvenience. These results are consistent with the results of a study we conducted among our hospital nursing aides. However, our study revealed 2 other barriers to the adoption of gloving.

We studied compliance with the use of personal protective equipment (PPE) among 121 nursing aides (NA) when they had self-reported exposure to biological hazards and to chemical hazards.Reference Pougnet, Garlantézec, Sawicki, Loddé, Eniaffe-Eveillard, Le Menn and Dewitte 3 Indeed, nursing aides can also be exposed to chemical contamination risk, in particular when they handle antineoplastic drugs.Reference Boiano, Steege and Sweeney 4 We used 2 criteria to assess the PPE compliance rate: (1) the use of gloves when there was a risk and (2) the appropriate use of gloves to counter the risk. We analyzed their work and administered a self-reported questionnaire regarding their knowledge of hospital PPE rules.

For biological hazards, compliance rates in our sample were between 67% and 77%. However, the nursing aides in pediatric units were not as compliant, in particular, in caring for babies. The compliance rates were only 30% when nursing aides in pediatric units were exposed to infantile disease. The non-compliant nursing aides used alcohol-based hand products between patients, so there was no risk of cross-transmission of infection to the patients. Most nursing aides explained their actions by claiming potential harm to the patient–provider relationship if gloves were used.

For chemical hazards, the compliance rates were between 75% and 100%. When we asked why some nursing aides did not use PPE to counter chemical risk, their answers revealed another barrier to PPE use. Some nursing aides thought that vinyl gloves were reserved for non-HCWs and/or projected a social image of janitorial staff. Additionally, nursing aides thought that only latex gloves projected the image of healthcare professionals. This belief prevented them from following PPE rules.

These results compliment the study by Masroor et al.Reference Masroor, Donovan, Sanogo, Couture, Ober, Stevens and Bearman 1 It is important to consider the perceptions of HCWs to promote gloving. Sociological representations can influence the behavior of HCWs. Furthermore, compliance is usually higher for some kinds of care (eg, surgical procedures, etc).Reference Goudra, Singh and Galvin 5 Certainly, it would be easy to assume that universal gloving prevents these sociologic phenomena.6 Indeed, the population will gradually accept gloving, but these social barriers may remain a limiting factor as this change is more universally implemented in the coming years because it often takes a long time to change mindsets and behaviors.

ACKNOWLEDGMENTS

Financial support: No financial support was provided relevant to this article.

Potential conflicts of interest: All authors report no conflicts of interest relevant to this article.

References

REFERENCES

1. Masroor, N, Donovan, SD, Sanogo, K, Couture, L, Ober, J, Stevens, MP, Bearman, G. Perceptions and barriers to universal gloving for infection prevention: a survey of healthcare workers and patients. Infect Control Hosp Epidemiol 2015;4:12.Google Scholar
2. Turco, M, Chalaye, C, Poulard, E, Gocko, C, Neyron, C, Courbon, G, Berthelot, P. Evaluating the impact of pluridisciplinary training on proper glove use in hospital. Med Mal Infect 2014;44:268274.Google Scholar
3. Pougnet, R, Garlantézec, R, Sawicki, B, Loddé, B, Eniaffe-Eveillard, BM, Le Menn, A, Dewitte, JD. Expositions aux produits biologiques et chimiques des aides-soignants d’un CHRU: fréquence d’exposition et conformité du port des équipements de protection. Arch Mal Pro 2012;73:919.Google Scholar
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6. Yin, J, Schweizer, ML, Herwaldt, LA, Pottinger, JM, Perencevich, EN. Benefits of universal gloving on hospital-acquired infections in acute care pediatric units. Pediatrics 2013;131:e1515e1520.CrossRefGoogle ScholarPubMed