Sally Knocker, consultant for Meaningful Care Matters kindly shares the following with Care Sector Hub…
In the UK, we may be beyond the spike in the coronavirus pandemic, but we are still reminded daily of the crisis through people’s very visible infection control choices. Take going to the local supermarket or shops, for example, you will surely come across many, if not most staff wearing protective plastic gloves.
Initially, this safety procedure conveys confidence to us that the managers are looking after their staff and customers, and we therefore feel reassured. Next time you go to the shops, however, a quick observation of the cashier will reveal how that person uses the very same gloves to touch multiple customers’ shopping purchases. The gloves may not be changed for hours if at all for the duration of their shift. The use of gloves creates an illusion of safety, but in reality, this is not practical or effective in adhering to stringent infection control.
In care settings, gloves are considered an essential component in terms of infection control practices, however just as the skin, they can be compromised and actually perpetuate infection if we do not use them correctly for single use. When gloves are changed, are people consistently undertaking rigorous hand hygiene before donning the next set for example?
Great Ormond Street Hospital has been running a campaign called ‘Gloves off: safer in our hands’ to reduce the use of gloves in healthcare environments, not least because of the environmental and financial impact. Ironically, infection control audits at Great Ormond Street Hospital for Children NHS Foundation Trust found that one of the key reasons clinical staff failed to comply to hand hygiene requirements was due to glove overuse.
Whilst there will always be situations where gloves are essential in care environments, it is important to remember that there are also other ways of keeping people safe. In some care homes, for example, we are hearing about imaginative ways to encourage people living in the home to wash their hands regularly. Helping to wash up dishes or bathing a baby doll in hot soapy water, a technique used in many dementia care settings, have proven fun and creative ways to stay safe and avoid the unnecessary layers of plastic.
At Meaningful Care Matters, our constant focus during this time with the care services with whom we work has been to ensure emotional wellbeing as well as physical safety. Human touch is a core part of connecting with another human being, and direct skin contact can communicate comfort, warmth and a loving intention. However, safety barriers such as gloves and other PPE can have the opposite effect. When supporting people living with dementia, for example, a person approaching wearing extensive PPE might look very frightening. I remember one incident in a care home where a woman who had spilt cornflakes and milk down her top was approached by two carers in blue gloves bearing swiftly down over her to clean her up. They meant well, but to the woman concerned, she felt under attack and lashed out in fear – a natural response to something unfamiliar. The carers were obviously upset and couldn’t understand what they had done wrong. What’s worse is that they blamed it on the woman’s deteriorating dementia. I asked them to sit down and repeat what had happened with me while I stood above them wearing blue plastic gloves and an apron, touching and wiping their chest without any warning. They had a direct experience of how it had felt for the woman and immediately understood the situation. We agreed that the message behind the gloves was that “I am in charge” and “I have a job to do”, rather than “I am here to help” and “I care about you.”
Ultimately, the skin is our bodies’ primary defence system against infections which is similar to the purpose behind gloves. If we wash hands frequently following the correct guidance and safety procedures, we should surely not be prevented indefinitely from enjoying the skin-to-skin contact of loving and meaningful human touch that we are so accustomed to enjoying in social care settings. Let’s strip back the plastic!
Sally Knocker is a consultant at Meaningful Care Matters, a leading care and organisational development group that specialises in helping health and social care providers to access a variety of support services. The group helps to facilitate the creation, reinvigoration and sustainable implementation of person-centred care cultures where people matter, feelings matter, and we are ‘Free to be Me’.