As the COVID-19 pandemic rages ever forward, there have been endless discussions in the medical and civilian community about the proper usage of personal protective equipment (PPE). While PPE has always been a standard of practice in many professions, its proper usage is relatively new to the civilian population. All of the sudden, seemingly overnight, people were asked to wear masks in public places. A lot of importance was placed on why people should be wearing masks, but not a lot of education was being done on how to place and remove PPE safely without contaminating themselves or the environment around them. As a nurse who is passionate about infection control practices, I find myself struggling with the number of people I see in public on a daily basis using PPE improperly. I believe that better education on proper PPE usage will help us move forward and make better progress towards COVID-19 eradication. While it is generally agreed upon that mask-wearing prevents the spread of respiratory illnesses, what is not disseminated to the general public is the effectiveness (or ineffectiveness rather) of wearing disposable gloves.
Throughout the pandemic, I have seen many people wear disposable gloves while in public, everyone from mail carriers, gas station attendants, grocery store workers, and regular people out shopping. But when is glove-wearing appropriate? Who needs to wear gloves when performing their job duties and who doesn’t? Do any of these people know how to remove gloves safely?
It is known in the infectious disease community that the main problem with glove-wearing is that people aren’t removing and disposing of their gloves properly, which ultimately defeats the purpose of wearing them. Additionally, while wearing gloves, people feel emboldened to touch everything they please – including their faces, leading to an increased amount of self-contamination. Wearing gloves only provides good protection if the person wearing the gloves follows good protective measures, and unfortunately, this is not usually the case.
The reason health care workers can both wear gloves and effectively prevent the spread of infection is because they have been properly trained on how to don and doff PPE properly. Glove removal is an integral part of patient care. Our training course has an entire video dedicated to glove removal, and our students are rigorously trained on how to remove gloves properly. Embarrassingly enough, glove removal was one of the first things I was ever “called out on” as a new nurse. I vividly remember the situation as it has stuck with me ever since. I was walking out of a patient’s room with gloves on. I quickly threw them in the trash in the hallway and walked towards the supply room. Little did I know, an infection control nurse was doing rounds and saw my transgression. She immediately came up to me and asked me why I didn’t sanitize my hands after removing my gloves. I was stunned. I didn’t know what to say because I was so embarrassed. I knew better and was trained better than that. I was apologetic and immediately washed my hands.
Now, knowing this story, think of all of the times out in public you have seen people take off disposable gloves and not IMMEDIATELY wash their hands? I think they have not been educated on why it is so important to do so. It is crucial to wash and/or sanitize your hands directly after removing gloves. There are many reasons for this but the most important reason is that pathogens can spread and multiply underneath your gloves! Gloves provide the perfect environment for pathogens to grow. It is warm (body heat), dark (gloves are pretty opaque), and moist (sweat). Even if your hands are 100% clean (which is unattainable really) when you put gloves on, the moment you place the gloves pathogens start to grow and multiply underneath. This is why it is so very important to remove gloves correctly and sanitize your hands immediately after glove removal. Additionally, it is important to remember to dispose of gloves directly into the garbage after removal. Gloves are not a substitute for hand hygiene!
Inappropriately wearing gloves in public likely sets us up to further the spread of infection, not prevent it. It may even be possible that COVID-19 could stick to gloves more effectively than it does to the skin. Let’s do our part by only wearing gloves when we know for certain it is indicated, such as direct body fluid exposure (drawing blood, emptying bodily fluids, etc), and not during routine grocery store trips. Educate yourself and others on how to remove gloves properly. Always remember, good hand hygiene is the best way to break the chain of infection. Wash your hands well and often.
Christina Brown MSN, RN