Researchers in England have uncovered a most unlikely deterrent to good hand hygiene: gloves.

Healthcare workers who wear gloves during patient care activities are much less likely to clean their hands before and after patient contact, according to a study published in the December issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

Remind your staff that they should never consider the use of gloves a substitute for effective hand hygiene practices taking place before and after patient contact, researchers say. Obviously gloves can reduce the number of germs transmitted to the hands, but germs can sometimes still get through latex. Researchers also point out that hands can also be contaminated by "back spray" when gloves are removed after contact with body fluids.

In one of the largest and most detailed studies on gloves and their impact on hand hygiene, researchers observed more than 7,000 patient contacts in 56 intensive care and acute care of the elderly wards in 15 United Kingdom hospitals. Overall, the study found that hand hygiene compliance was a "disappointingly low" 47.7%, but compliance was even lower (41%) when gloves were worn.

"The chances of hands being cleaned before or after patient contact appear to be substantially lower if gloves were being worn," says the principal investigator. "We call this the phenomenon of the 'Dirty Hand in the Latex Glove.'"

Researchers suggest further study on the behavioral reasons behind why healthcare workers are less likely to wash their hands when wearing gloves.

Dan O'Connor