The gloves are off!

1.4 billion gloves are used across the NHS each year. To combat this, Lead Infection Prevention Control Nurse Helen Dunn, and Practice Educators Amy Leonard and Nicola Wilson at Great Ormond Street Hospital (GOSH) are on a mission to encourage healthcare professionals to reduce unnecessary use of non-sterile gloves.

We spoke to Nicola to find out more about the campaign and the impact it has had so far.

Wearing plastic gloves is an engrained behaviour common to hospital staff. “Research says that nurses and other healthcare professionals put on gloves because they think it is protecting their patient in some way,” Nicola explains “But it’s not. The gloves used are non-sterile nitrile gloves, so your clean hands are better for patients. We should only wear those gloves if we’re going to come into contact with a bodily fluid, non-intact skin, or mucus membrane.”

By working with Quality Improvement colleagues, the team found that around 200,000 pairs of gloves were being ordered a week. Skin issues and contact dermatitis, suspected to be caused by the gloves, were frequently being reported by nurses too.

All of these drivers lead Nicola, Helen and Amy to devising their ‘Gloves Are Off’ campaign, with the aim to reduce glove usage and promote the key message that ‘all staff be asked to risk assess when they use gloves’.

Nicola explains how they launched their staff campaign at GOSH: “We decided to launch with the National Hand Hygiene day in April 2018. But to do it we realised that it isn’t just nurses we need to teach – how can we educate the most staff groups possible? So we got internal comms involved and we wrote a Train the Trainer package, and all the educators took it across the Trust to teach all their Nursing staff and Healthcare Assistants. We also went and talked to the Porters, Occupational Therapists, Physios, Pharmacists, GOSH school staff; as many as we could ready for that day. The more people heard about it, the more they engaged.”

And the focus wasn’t just on gloves usage – staff were challenged to consider reducing their use of aprons and syringe bungs too.

Nicola shares how the campaign has already had a significant impact, resulting in environmental benefits, as well as improving staff and patient wellbeing:

“What we also found a year later is that people’s hands are healthier. We’ve had people take photos of their hands before and after. Previously, a lot of people couldn’t do non-clinical work because when the hands are so red and chapped you can’t put them under hot water anymore because it stings so much, so it’s really nice to hear the reduction in glove use has helped.

“We’ve seen no adverse rise in infections as a result of the way we use gloves now which is really positive.”

The campaign has had notable patient benefits too: “We had a phone call from a dad with a child at GOSH who has learning disabilities. He explained that because people would often put on gloves before they did almost anything with his child, the child’s phobia was stimulated by them. The anxiety levels in his child have been lowered so much as the gloves are no longer there to stimulate the anxiety.”

Nicola, Amy and Helen have been busy presenting their findings and are keen that other Trusts implement this approach too.

“Although it sounds like it’s just a pair of gloves you’re putting on, culturally it’s a massive difference. Because you do thousands of your IV practice (as a nurse) you have this muscle memory to just pick up a pair of gloves. So you’ve really got to get it engrained and change practice.

“I hope other Trusts are as successful. We’re a relatively small Trust in comparison to other places. If we’ve saved 21 tonnes of plastic, their savings too could be massive.”

Left to right: Nicola Wilson, Helen Dunn, Amy Leonard