Introduction

“Standard hygiene measures” refer to general measures which contribute to avoiding the transmission of pathogens. Among other things, these are composed of hand hygiene and the use of personal protective equipment. Particular focus is to be placed on the use of medical single-use non-sterile gloves. In the following, “gloves” always refer to such medical single-use none-sterile gloves.

Gloves are necessary, for instance, during activities where contact with body fluids, excretions, or substances which cause damage to skin may occur [1], [2], [3], [4], [5]. However, in current national initiatives for recording compliance data, such as the clean-hands campaign “Aktion Saubere Hände” (ASH), the appropriate use of gloves and hand disinfection before and after the use of gloves in accordance with guidelines is not listed or tested separately. Currently, explicit data are lacking which depict the use of gloves and the hygiene measures that must accompany it.

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It can be assumed that gloves are worn on a daily basis by almost all clinical employees. The transmission of pathogens via blood or other potentially infectious materials is to be prevented by gloves [1], [2], [3], [4], [5]. Wearing gloves is necessary for a number of reasons. For instance, in case of high contamination of the hands with pathogens, not all of the pathogenic microorganisms can be killed by hand disinfection [6], [7]. Despite this important function of gloves [8], [9], [10], they must, as applies for all infection prevention tools, be correctly used and the time point at which they are used should be critically evaluated. Several authors have already described the problem of gloves being overused or used at the wrong moment [11], [12], which – in the worst case scenario, i.e, a contamination event – results in gloves being vectors for the potential transmission of pathogens [13].

Alongside the correct time point for glove use, the appropriate use of gloves in itself involves the disinfection of hands before and after wearing them, as well as the disinfection of hands according to the WHO rules of the “5 Moments” [1], [14]. In order to appropriately implement these “5 Moments”, the gloves must be taken off using the correct technique, hands thoroughly disinfected taking into consideration the exposure time and subsequently putting on new gloves, provided the indication to wear gloves continues to exist [6], [9], [14]. This complex procedure not only takes time, it also provides several opportunities for error. For instance, disinfection before and after gloves use may be forgotten, the gloves are not changed or changed at the wrong moment, or put on even though the hands are still wet from disinfectant. All of this involves risks for patients with regard to the transmission of pathogens and for the person administering the treatment, who could contaminate themselves and their environment [15]. In the event of inadequate exposure time to the disinfectant before the use of gloves and therefore donning gloves with hands which are still wet, there is also an increased risk of contracting dermatitis or an increased risk of perforating the gloves [16], [17], [18].

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Throughout this paper different terminology concerning “compliance” will be used. For better understanding, the definitions are given below.

The basic assumption of the investigation was that the use of gloves represents a barrier to correct hand hygiene behaviour. This study examined this assumption and sought to identify the reasons for possible incorrect behaviour. Accordingly, the hypothesis is that peri-glove compliance is lower than hand disinfection compliance at Leipzig University Hospital.

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