The Royal College of Nursing’s (RCN) Glove Awareness Week (GAW) is an annual event and this year it is more important and relevant than ever. Piloted in 2018 to support implementation of Tools of the Trade guidance, this awareness raising week exists to focus attention on the unintended consequences of wearing gloves when not required as personal protective equipment (PPE). Using gloves when not required has a negative impact on the prevention of infection, skin health, and planetary health. This year, in acknowledgement of the covid-19 pandemic and the exhaustion of many frontline healthcare workers, the messages and contributions for glove awareness week focus on the ability to “Make One Change” that reflects an achievable personal, team, or organisational action based on local need.
The need for PPE to protect healthcare workers has never been greater. During the covid-19 pandemic, the function of PPE—to protect the wearer from harmful substances—translates predominantly to managing exposure to SARS-CoV-2 and environmental disinfectants used for cleaning. The direct translation of infection prevention guidance with standard and transmission based precautions, has led many frontline healthcare workers to wear gloves for everything, regardless of recognised conventional risks such as blood and body fluids or mucous membrane exposure. Familiar media images of staff clapping with gloves on, or wearing gloves for vaccination, using computers, or pushing beds and trolleys, all contribute to the new culture of excessive glove use. The impact is a pandemic of sore hands and escalating anxiety about the environmental impact of our behaviours at work. For many, a simple change lies in identifying one situation where gloves are not required—for example, at the computer, talking to patients and carers, making beds, or even pushing patients in trolleys and chairs. For nurses in particular the impact of wearing gloves while holding hands has become a red line for compassionate care. Glove Awareness Week offers an opportunity for reflection and an opportunity to turn the tide of routine glove use.
The importance of skin health is inextricably linked to glove use. A high prevalence of skin problems among nursing staff risks increased sickness absence in an already depleted and exhausted workforce. A reluctance to report skin problems and the impact that this has on hand hygiene or glove use as a consequence of aggravated skin, is a priority for employers and regulators to urgently address. As the largest organ in the body, healthy skin is vital. The cocktail of irritants and allergenic substances that many healthcare workers are exposed to at work is the root cause of skin problems. Wearing gloves for long periods of time overhydrates hands resulting in “soggy skin” and disrupting its natural barrier function. In the race to protect ourselves from SARS-C0V-2, glove use has increased exponentially. If we follow the rules of clinical indications for hand hygiene, glove use, and use of hand sanitizers between changing gloves, it is the skin on our hands that face the greatest challenge as the first line of defence for us and our patient’s safety. Managing this means focusing on fundamental action such as strategies for promoting and supporting good hand care at work, providing and encouraging staff to use hand creams during shifts, and reporting and collecting data on skin symptoms. Fast tracking staff to specialists where indicated must not be seen as a “perk” of the job, but a necessity if we are to retain staff. They are our most valuable assets. As with any improvement programme, data is key. This GAW2021, making one change to improve our skin health could make all the difference to staff’s wellbeing and overall health.
For our planetary health, action and change are critical. Healthcare workers are acutely aware of the environmental impact of the demand and use of PPE during the pandemic. There is now a growing sense of urgency to address this and implement innovation in support of reuse or recycling of equipment when possible, particularly PPE. Gloves are single use items, and the combined sustainability impact of manufacturing, transport, and incineration of predominantly nitrile gloves used in the NHS is staggering. The simple act of putting on a glove is far removed from the process used to create it. Derived from fossil fuels extracted on the other side of the world, the use of human labour, energy, and water comes at an environmental cost with toxic emissions adding to this burden. In this most important year of climate action, ahead of COP26 in November, we find ourselves at a crucial point for action to mitigate climate change. Gloves represent only the tip of the iceberg, but with 1.4 billion gloves used in the NHS in England alone pre covid-19, the pressure is really on to reduce unnecessary use and waste and to focus on wider procurement and consumable use as a major contributor to the NHS’ climate action.
So this year the opportunity to “Make one change” extends far beyond glove awareness week. The opportunity to be part of something much bigger that affects the whole planet and global health is something we cannot ignore. Join the Royal College of Nursing this week (3rd-7th May) and “Make one change” for your health, our patients, and our planet.
Rose Gallagher, Professional lead Infection Prevention and Control, Royal College of Nursing @gallagher_rose #GAW2021
Competing interests: none declared