“CDC guidelines emphasize hand hygiene relative to patient contact or contact with patient surroundings. If a healthcare worker prepares for direct patient contact requiring gloves, he or she should perform hand hygiene per the before-patient-contact recommendation.
The WHO’s glove use information leaflet more explicitly states that “when an indication for hand hygiene precedes a contact that also requires glove usage, hand rubbing or hand washing should be performed before donning sterile gloves.” This wording has led some facilities to mandate hand hygiene immediately before nonsterile glove use. However, the indication was intended to relate to the patient contact rather than the act of donning gloves.
Contamination of unused gloves in boxes is one concern motivating institution-specific policies for hand hygiene before nonsterile glove use. An early study showed that gloves in boxes were not subject to significant contamination throughout duration of box use, regardless of the duration of time that the boxes were open. However, researchers in an orthopedic ward in New Zealand found contamination of 13.2% of unused nonsterile gloves with potential pathogens, albeit in low numbers,suggesting that hand hygiene before reaching for gloves or a different design for glove boxes may be important.
Controversy has persisted about the need for hand hygiene prior to donning nonsterile gloves. A 1995 study found that there was no significant difference in colony-forming units on healthcare worker hands between the group that washed hands and examined patients with bare hands compared with the group that donned gloves with or without prior hand washing. Similarly, a 2013 study reported no significant difference in glove contamination between groups that did and did not sanitize hands prior to donning gloves.”
Hand-in-Scan suggests following the WHO guidance to perform hand rubbing or hand washing before gloves.