Healthcare workers’ knowledge and attitudes to glove use Flores A 1 , Pevalin DJ 2 1. Senior Nurse Infection Control, Infection Control Department, Mayday Healthcare NHS Trust, Mayday University Hospital, 530 London Road, Croydon CR7 7YE 2. Lecturer, Department of Health and Human Sciences, University of Essex, Wivenhoe Park, Colchester CO4 3SQ he aim of this study was to examine healthcare workers’ knowledge and attitudes to glove use. A cross-sectional survey was carried out in two district general hospitals in southern England, using a self-completion questionnaire. The results showed a good overall knowledge of glove use, although knowl- edge could be improved in relation to standard precautions. Respondents had positive attitudes towards the use of gloves to protect against acquiring an infection, the availability of gloves, and acting as a role model to other staff. Respondents had negative attitudes towards the effect of gloves on dexterity. Interventions could be aimed at staff education and training regarding glove use. Attitudes to glove use could be improved by interventions that emphasise the advantages of wearing gloves and counteract the per- ceived disadvantages. Introduction The aim of wearing gloves is to reduce the risks of cross-infection from staff to patients and vice versa, to reduce transient contam- ination of the hands of personnel by micro-organisms that can be transmitted from one patient to another, and to protect users’ hands from chemicals (ICNA, 2002). Evidence for the efficacy of glove use in the prevention of con- tamination of healthcare worker’s hands, and in the reduction of transmission of micro-organisms, has been demonstrated in a number of studies (e.g. Tenorio et al, 2001; Hartstein et al, 1995). Pratt et al (2001) recommended that gloves must be worn for invasive procedures, contact with sterile sites, non-intact skin, mucous membranes, and for risk of exposure to blood, body flu- ids, and sharp or contaminated instruments. Gloves must be worn only once for one aspect of care and one patient (Pratt et al, 2001). Knowledge and attitudes to glove use have been examined in the literature, but mainly in relation to universal precautions (now termed standard precautions). Stein et al (2003) examined doctors’ and nurses’ knowledge, attitudes and compliance with universal precautions, and found that doctors and nurses differed significantly in their attitudes to and reported compliance with wearing gloves when taking blood. Doctors especially reported low compliance. Trim et al (2003) measured knowledge of inoculation injury and glove use using a survey and found that despite educational programmes, policies and awareness campaigns, knowledge and compliance remained inadequate, with gloves not being routinely worn according to recommendations. In order to reduce the incidence of nosocomial infection and reduce occupational exposure to communicable disease among healthcare workers, a major challenge for infection control spe- cialists is changing practice. They need to have an understanding of the factors influencing staff behaviour, including glove use. Aim The aim of this research was to examine healthcare workers’ knowledge and attitudes to glove use. Differences in knowledge and attitudes between clinical directorates and different profes- sions – nurses, doctors and healthcare assistants – were also examined. Methods This study took place in a large acute hospital Trust serving south-west London and Surrey, consisting of two district gener- al hospitals. The data collection took place throughout February to April 2005. The self-completion survey was based on hospital policy for glove use, which in turn is based on national guidelines. Some questions were adapted from existing questionnaires (Pittet et al, 2004; Stein et al, 2003). The questionnaire was validated in a pilot study before implementation. The sex and professional group of respondents was recorded. In order to measure knowledge, nine questions regarding glove use were presented. Knowledge questions were given a zero mark for an incorrect response and a mark of one for a correct response, therefore the range of possible scores was zero to nine. In order to measure attitudes, participants were presented with two sections – ‘attitudes to glove use’ and ‘perceived importance of glove use’. In the section ‘attitudes to glove use’, participants were pre- sented with seven statements about glove use, and asked to rate their responses on a Likert-type five-point scale of how much they agree or disagree with each statement. In the section ‘perceived importance of glove use’, respondents were asked to rate how important they thought glove use was during specific activities. Answers were recorded on a three-point scale – very important, important or not important. Having scored each item, the scores 18 British Journal of Infection Control OCTOBER 2006 VOL. 7 NO. 5 Key words: Gloves, healthcare workers, knowledge, attitudes, standard precautions Abstract Double-blind peer reviewed paper T Accepted for publication: 12 August 2006