the need for hand hygiene, nor does hand hygiene eliminate the need for gloves (CDC, 2003, 5). The use of gloves reduces hand contamination by 70 percent to 80 percent, prevents cross-contamination, and protects patients and healthcare professionals from infections. Gloves should be changed before and after each patient, and hand rubs should be used before and after each patient. If an alcohol-based hand rub is to be used, it should be applied to the palm of one hand and the two hands rubbed together so that all surfaces of the hands and fingers are covered with the rub, and rubbing should be continued until the hands are dry. The volume of alcohol-based rub needed to reduce the number of bacteria will vary with the product used, and so users should become familiar with different products and their effectiveness. When products are selected for use, their relative efficacy against various pathogens and the acceptability of the products by the personnel needs to be considered, e.g. smell, consistency, color, and how much the product dries the hands.
There are certain circumstances when the CDC does not believe alcohol-based hand rubs can be used and that soap and water should be used (Morantz and Torrey, 2003, 1135). These occasions include: before having direct contact with patients; before donning sterile gloves to insert a central intravascular catheter; before inserting indwelling urinary catheters, peripheral vascular catheters, or other invasive devices that do not require a surgical procedure; after contact with a patientÆs intact skin (taking a pulse or blood pressure); after contact with body fluids or secretions, mucous membranes, non-intact skin, and wound dressings, if hands are not visibly soiled; when moving from a contaminated-body site to a clean-body site during patient care; after contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient; and after removing gloves....