Hand Hygiene and Gloving: Are We Getting It Wrong? Lessons from Medtech's Masterclass

Our infection prevention masterclass, "Hand Hygiene and Gloving: Are We Getting It Wrong?", drew one of the liveliest discussions we have hosted. The premise was deliberately uncomfortable. Hand hygiene is the most rehearsed ritual in healthcare, and yet compliance audits across health systems keep finding the same gaps, in the same places, year after year. This article turns the masterclass into an evergreen reference for clinical teams in Mauritius.

The five moments, and the two we miss

The World Health Organization's five moments framework is familiar to every participant we hosted: before patient contact, before an aseptic task, after body fluid exposure risk, after patient contact, and after contact with patient surroundings.

The masterclass discussion, echoing published compliance audits, kept returning to two weak points:

• Before patient contact, the moment most often skipped when workload spikes, and
• After contact with patient surroundings, the moment staff most often fail to register as an exposure at all.

Neither gap is a knowledge problem. Every participant could recite the five moments from memory. Both are workflow and culture problems, which is why audit and feedback, not another poster above the sink, are the interventions that actually move behaviour.

The glove is not a substitute for the hand

The single most common error the masterclass surfaced is treating gloves as a replacement for hand hygiene rather than an addition to it. Gloves reduce contamination. They do not eliminate it. Perforations happen silently during use, and microorganisms transfer to the hands during removal, which is why hands must be decontaminated before donning and after doffing, every single time.

The second error is over-gloving: wearing the same pair between patients, between tasks, from bedside to keyboard. A contaminated glove touched to a door handle spreads organisms exactly as effectively as a contaminated hand, with the added harm of false confidence. Gloves are task-specific, single-use tools, not personal equipment for a shift.

Choosing the right glove for the task

A glove is a medical device, and selection is a clinical decision, not a stores decision. We supply the Molnlycke and Ansell ranges across Mauritius, and the selection conversation with clinical teams covers:

• Sterile surgical versus examination gloves, matched to the invasiveness of the task rather than habit or availability.
• Material. Latex sensitivity in staff and patients pushes many departments toward synthetic options such as polyisoprene and neoprene for surgery, and nitrile for examination use. A department policy beats individual improvisation.
• Task-specific ratings, including gloves rated for handling cytotoxic agents and for prolonged procedures where fatigue and moisture degrade performance.
• Fit. A poorly sized glove tears more, tires the hand faster and degrades technique. Fit assessment belongs in onboarding, not folklore.

The double gloving question

Surgical teams gave this topic the most airtime, and the evidence discussion was refreshingly settled. Systematic reviews consistently report that double gloving substantially reduces perforations of the inner glove compared with single gloving, and the inner glove is the layer that matters for both patient and surgeon. Coloured indicator systems, a darker under-glove worn beneath a standard outer glove, make outer-layer breaches visible at the table instead of being discovered at doffing, or never.

The objections are familiar: dexterity, tactile sensation, habit. The published experience is equally familiar: most surgeons adapt within a small number of cases and stop noticing the second layer. For high-risk work, orthopaedic and trauma surgery in particular, many departments now write double gloving with indicator systems directly into protocol, and the masterclass consensus supported that direction.

Doffing is a procedure, not a pause

Removal technique received its own practical session, because contaminated gloves protect nobody at the moment they come off. The sequence is simple and worth rehearsing until it is automatic: glove-to-glove for the first cuff, skin-to-skin for the second, no snapping, straight to disposal, then hand hygiene immediately. The same discipline applies to gowns and surface contact on the way out of the room. Teams that rehearse doffing treat it as part of the task. Teams that do not treat it as the walk to the bin.

Making it stick: from masterclass to habit

One study day changes nothing by itself. The follow-up pathway we build with clinical teams looks like this:

• Short, repeated refreshers through the Mauritius Talent LMS rather than a single annual lecture, because retention follows repetition.
• CPD sessions delivered with local accredited providers, so learning counts toward professional development and attendance is easier to justify.
• Audit and feedback cycles owned by the unit, measuring the two weak moments above rather than everything at once.
• Product standardisation: a rationalised glove formulary, agreed with clinicians, so the right glove is always the one within reach.

The consumables that back the protocol

Protocols fail quietly when the right glove is not in the dispenser. Supply reliability is part of infection prevention, which is why we back gloving programmes with consignment stock held on site, monitored and replenished by us. Our Wound Care portfolio includes the Molnlycke and Ansell gloving ranges alongside advanced dressings, because infection prevention and wound management are one conversation, not two.

If your team wants the masterclass delivered in-house, or a structured review of your glove formulary and hygiene audit programme, reach us through the contact page and we will set it up with your infection control lead.