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Hand washing is the single most important way to prevent the transmission of infections.1 Health care providers have been educated for more than a century that hands must be decontaminated before and after each patient contact, when hands are visibly soiled, before donning gloves, and after removing gloves.
Current hand hygiene guidelines recommend that health care providers wear gloves to prevent transmission of flora to patients and to reduce the risk of acquiring infections from patients.1 The Occupational Safety and Health Administration requires health care providers to use barriers, such as gloves, when they are likely to have contact with blood or other potentially infectious materials, mucous membranes, and nonintact skin; when they perform vascular access procedures; and when they handle or touch contaminated surfaces or items.2
Unfortunately, many health care providers use gloves as a substitute for hand hygiene. Gloves are an excellent barrier that can reduce hand contamination by 70% to 80%, but gloves break easily and can facilitate the growth of bacteria.3 Wearing gloves creates a moist, warm, nutrient-rich environment (ie, powder from the gloves and oil from the skin) in which bacteria can grow and multiply. Bacteria grow and multiply by binary fission,4 which makes transmission and development of infection more likely in the presence of large numbers of circulating bacteria. All of these variables synchronize when gloves...