Comment

PPE is vital, but gloves are no substitute for hand hygiene

Hand hygiene remains the key to preventing the spread of infection

Its important nurses remember hand hygiene remains the key to preventing the spread of infection

Picture: iStock

Amid the huge challenges posed by the COVID-19 pandemic, nurses have been faced with situations they would never have conceived of when they entered the profession.

Planning for a pandemic is not new, and many nurses will have been part of it, through table-top exercises, policy reviews or development, or as specialists in infection prevention and control or emergency planning.

PPE has been a major factor in the pandemic response

However, words on paper contrast starkly with the reality. The practical and logistical challenges presented by staff sickness and absence due to self-isolation and shielding, the return of retired nurses and students stepping up to provide support have required an amazing feat of

It’s important nurses remember hand hygiene remains the key to preventing the spread of infection

Picture: iStock

Amid the huge challenges posed by the COVID-19 pandemic, nurses have been faced with situations they would never have conceived of when they entered the profession.

Planning for a pandemic is not new, and many nurses will have been part of it, through table-top exercises, policy reviews or development, or as specialists in infection prevention and control or emergency planning.

PPE has been a major factor in the pandemic response

However, words on paper contrast starkly with the reality. The practical and logistical challenges presented by staff sickness and absence due to self-isolation and shielding, the return of retired nurses and students stepping up to provide support have required an amazing feat of organisation, dedication and tenacity by our profession.

One of the biggest issues nursing staff have faced, whatever setting they work in, has been access to personal protective equipment (PPE). We know it has created huge challenges, both physical and ethical, and this has to be one of the most enduring lessons from this pandemic.

The impact of wearing PPE on individuals, and their skin

Having the right protective equipment is accepted as a priority and a right for healthcare workers in all settings. It protects them and their patients.

Two key factors influence the health and safety of nursing staff – procurement decisions and how we use PPE.

This pandemic has highlighted the complexities and challenges of procurement, supply and distribution of what until January were considered commonplace items we used on a daily basis – too commonplace, perhaps, to be acknowledged for their true importance.

The impact on the individual of wearing PPE, and specifically on their skin, is an emerging issue. While much of the media focus has been on gowns and eye and face protection, we must not forget the examination gloves that are being worn frequently and for long periods of time.

Gloves are often the go-to solution, despite the ‘gloves off’ movement

Nurses know only too well that if their hands become damaged it can have long-term consequences on their health, as well as their career.

‘It is concerning to see glove use increase in situations where hand hygiene is most effective and protective’

Every year some people have to leave front-line nursing because of the long-term effects of damage to their hands.

Experience tells us that using gloves is often the go-to solution, an automatic default, even though the ‘gloves off’ movement and messages to avoid glove use unless it is specifically required have been gaining momentum.

It is concerning to see glove use increase in situations where hand hygiene is most effective and protective.

Many staff do not receive training in protecting their hands at work

Protecting our skin as key tools in nursing is a priority.

The RCN has published guidance on the use of gloves, which includes detailed information on the importance of skin health. We knew this was needed. Our research, carried out before the COVID-19 pandemic, found more than half (58%) of 1,531 members who responded to our skin health survey said they had not had any training in how to protect their hands at work.

Nine out of ten (93%) said they had experienced some form of skin condition, including cracking, scaling and pain, in the previous 12 months.

There are some relatively simple steps that all healthcare workers can take to protect their hands, alongside the appropriate use of gloves, such as performing hand hygiene correctly and regularly applying hand moisturising creams, ideally containing emollients.

Even when used appropriately, gloves are not a substitute for hand hygiene

These steps, as well as being an important part of preventing the transmission of infection, can protect your hands and, in some cases, your career.

This is why it is so important that even when gloves are used appropriately they are not seen as a substitute for hand hygiene, which continues to be recognised as the most important thing any of us can do to prevent the spread of infection.

These may be extraordinary times, but it does not mean we should forget the fundamentals of care – for our patients and ourselves. These can be very easily neglected but can rapidly cause problems.

If we start with the hands the rest can follow far more easily, and once it becomes routine you will never forget.


Find out more

Sign up to continue reading for FREE

OR

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursing standard.com and the Nursing Standard app
  • Monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs