Reducing Unnecessary Glove Use: A Sustainable Approach to Infection Control

 14th January 2025

Written by Serakoule Traore (Senior Infection Prevention and Control Staff Nurse), Rana Begum (Trust-wide Lead Infection Prevention & Control Nurse), Valrie Burgess (Infection Prevention and Control Nurse), and Matt Oultram (Improvement Advisor)

The Infection Prevention & Control Team has been leading a Quality Improvement (QI) project to reduce unnecessary glove use in healthcare settings. This initiative aims to enhance patient safety and promote sustainability by addressing the overuse of gloves, which can lead to increased cross-contamination risks and significant environmental and financial impacts.

Under this QI project, clinical staff are advised to perform their own risk assessment before wearing gloves, as such: “Stop and think, am I at risk?”

The risks to staff in the workplace that require to wear gloves are:

• If contact with blood, bodily fluids, mucous membranes or non-intact skin is likely.
• If caring for a patient under isolation precautions.
• If contact with chemical hazards is likely.

As an example, gloves are not needed when touching a patient, washing a patient, changing a patient’s bed linen (unless visibly soiled), taking a patient’s blood pressure, dispensing medication, pushing a chair/trolley/bed, handing out or collecting meal trays, making and handing out hot and cold drinks. In ELFT, this QI project started in John Howard Centre and Tower Hamlets Centre for mental Health (THCMH). In both sites staff are recommended to no longer wear gloves when serving food to patients. THCMH has complemented by removing gloves when taking patients’ blood pressures.

The project is being carried out by the Infection Prevention Team alongside the Improvement Leaders Programme (ILP). We are supported by our QI Coach, Joshua John (Data and Analytics).

Rationale
Currently, the NHS purchases over 1.4 billion boxes of non-sterile gloves annually, costing around £35 million. During the pandemic, this number increased to 5.1 billion gloves. This project aims to reduce unnecessary glove use by 50% on wards by March 2025. The benefits of this are to improve patient safety, cut costs, and reduce environmental waste.

Learning about the problem

We set about putting together a fishbone diagram (Figure 1). This outlines a range of causes as to why gloves may be worn unnecessarily.

Figure 1: Learning about the problem: Fishbone diagram

Our theory of change
The driver diagram (Figure 2) outlines the project’s change ideas, focusing on gaps in knowledge, anxiety around infection control, and the need for accurate data collection. By addressing these areas, the team aims to promote a change in habits; ensuring gloves are worn only when necessary, such as during direct patient contact or handling soiled materials.

Figure 2: Driver diagram

Testing change ideas

We are currently testing 2 change ideas. Our first idea is to test a series of posters to raise awareness of unnecessary glove use and to encourage people not to use gloves where there is no requirement to. Posters have been designed, printed and displayed on the wards.

Our second change idea is that of a glove demonstration whereby a member of the Infection Control team demonstrates (to around 20 people) just how easily objects can become contaminated through the use of gloves. We show this through the use a reflective gel shown under a UV light.

An example of our data is as follows (Figure 3). Now that we have a method of collecting data, we will be reviewing this on a regular basis within our project team, to see whether our change ideas are resulting in an improvement.

Figure 3: Number of gloves used monthly – Tower Hamlets Community Mental Health

We will continue to test further change ideas such as promoting the use of hand sanitiser and frequent hand-washing as alternatives to using gloves, with the aim to reduce costs across the Trust.