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Handwashing and Glove Use in a Long-Term–Care Facility

Published online by Cambridge University Press:  02 January 2015

Betsy L. Thompson ,
Diane M. Dwyer ,
Xilla T. Ussery ,
Susan Denman ,
Pam Vacek  and
Benjamin Schwartz
Betsy L. Thompson*
Affiliation:
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemiology and Disease Control Program, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
Diane M. Dwyer
Affiliation:
Epidemiology and Disease Control Program, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
Xilla T. Ussery
Affiliation:
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia
Susan Denman
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Pam Vacek
Affiliation:
Biometry Facility, University of Vermont College of Medicine, Burlington, Vermont
Benjamin Schwartz
Affiliation:
National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia
*
CDC/NCCDPHP/Division of Adult and Community Health, 4770 Buford Hwy, Mailstop K30, Atlanta, GA 30341-3724
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Abstract

Objectives:

To determine glove use and handwashing practices, the factors associated with infection control practices, and the frequency of potential microbial transmission in a long-term–care facility (LTCF).

Design:

Observational study of 230 staff-resident interactions in an LTCF. We recorded resident characteristics, type of activity, staff credentials, and movements of the staff member's hands, then used the LTCF's guidelines to judge appropriateness of glove use and handwashing.

Setting:

255-bed, university-based LTCF in Baltimore, Maryland.

Participants:

A systematic sample of staff-resident interactions.

Results:

Gloves were worn in 139 (82%) of 170 interactions when indicated, but changed appropriately in only 21 (16%) of 132. Hands were washed when needed before an interaction in 27%, during an interaction in 0%, and after an interaction in 63%. Gloves were less likely to be used when caring for residents with gastrostomy tubes compared with other residents (relative risk, 0.85; 95% confidence interval, 0.73-0.98). Guidelines were followed more frequently during wound care than during other activities. Microbial transmission potentially could have occurred in 158 (82%) of 193 evaluable interactions.

Conclusions:

We documented marked deficiencies in glove use and handwashing, demonstrated the possible impact of these deficiencies, and identified factors associated with inadequate handwashing and glove use. This information can be used in future educational and research efforts to improve infection control practices.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 2 , February 1997 , pp. 97 - 103
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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