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Background/objective After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). Methods A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention. Results Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% confidence interval [CI] 51–59%) using powdered latex gloves and 60% (95% CI 57–63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI 2.5–7.6%, p Conclusion Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

Summary Objectives The purpose of this study was to compare methods for assessing compliance with hand hygiene in an intensive care unit (ICU), a step-down unit (SDU), and a hematology–oncology unit. Methods Over a 20-week period, we compared hand hygiene compliance measurements by three different methods: direct observation, electronic handwash counter for alcohol gel, and measuring the volume of product used (alcohol gel) in an ICU, an SDU, and a hematology–oncology unit of a tertiary care, private hospital. Results By direct observation we evaluated 1078 opportunities in the ICU, 1075 in the SDU, and 517 in the hematology–oncology unit, with compliance rates of 70.7%, 75.4%, and 73.3%, respectively. A total of 342 299, 235 914, and 248 698 hand hygiene episodes were recorded by the electronic devices in the ICU, SDU, and hematology–oncology unit, respectively. There were also 127.2ml, 85.3ml, and 67.6ml of alcohol gel used per patient-day in these units. We could find no correlation between the three methods. Conclusions Hand hygiene compliance was reasonably high in these units, as measured by direct observation. However, a lack of correlation with results obtained by other methodologies brings into question the validity of direct observation results, and suggests that periodic audits using other methods may be needed.