Introduction
The use of non-sterile clinical gloves (NSCG) in healthcare settings emerged in the mid-1980s as a measure to protect healthcare workers (HCWs) from exposure to blood-borne viruses in blood and body fluids (Centers for Disease Prevention & Control, 1988). The concept of ‘universal precautions’ recommended the use of protective clothing for direct contact with blood and blood-stained body fluids. This guidance was subsequently developed into the concept of Standard Precautions which advises that personal protective equipment (PPE) should be used for procedures where a risk of direct contact with any blood and body fluids (BBF) is anticipated (Loveday et al., 2014a; Royal College of Nursing, 2012; Seigel et al., 2007). These policies were based on the concept that pathogens that cause healthcare-associated infections (HCAIs) are most likely to be present in body fluids and using PPE in these situations reduces the risk of transference. Subsequently, the World Health Organization (WHO) guidelines on hand hygiene recognised the potential for NSCG to be over-used and provided guidance on when gloves are indicated and when they are not required (WHO, 2009). However, recent studies suggest that the use of NSCG has extended to a wide range of care activities that do not involve direct contact with BBF and their use has been associated with a risk of cross-contamination because they are put on too early, removed too late and acquire pathogens during use that can then be transferred to susceptible sites, or other surfaces and patients (Flores and Pevalin, 2006; Fuller et al., 2011; Girou et al., 2004; Loveday et al., 2014a, 2014b; Snyder et al., 2008).
There is therefore a need to address how HCWs use gloves to ensure that they are used appropriately and safely. To be successful, strategies focused on changing this behaviour need to take account of the key drivers of glove-use behaviour. In a previous study involving interviews with HCWs, we identified that both emotion and socialisation were important drivers of glove-use behaviour (Loveday et al., 2014b). While the main emotional drivers were linked to self-protection, perception of patient preference was also cited as a factor that influenced HCWs to use of NSCG. HCWs expressed views that patients preferred to see them wearing gloves as they conferred a sense of hygiene but also provided a form of emotional barrier against ‘intimacy’, for example for washing genital areas. However, HCWs also recognised that glove use interferes with the ‘therapeutic touch’ and could give patients the impression that they were somehow ‘dirty’ or contagious (Loveday et al., 2014b).
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There is a paucity of evidence about what the public actually think about HCW use of gloves and whether HCW perceptions of patient preference is borne out by their opinions. The aim of this study was therefore to explore the perceptions of the public about HCWs’ use of gloves and their experience of glove use in healthcare settings. In addition, we have explored the views of student nurses nearing the end of their training about situations when they would wear NSCG to determine the extent to which their attitudes matched those of patients and what influenced their decision-making. The information captured by this study will help inform infection prevention strategies directed at improving the use of NSCG to ensure that care delivered is both safe and acceptable to patients.
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