How and why do healthcare workers use gloves in two Norwegian nursing homes?

BACKGROUND: Incorrect glove use can cause cross-contamination and healthcare-associated infections. Previous research has identified reasons for this, such as lack of indication, improper changing, and poor hand hygiene post use. Limited research has investigated the reasons behind healthcare workers' glove usage. AIM: To develop an in-depth understanding of healthcare worker (HCW) attitudes and perceptions of glove use and to explore barriers and facilitators as well as compliance with national guidelines. METHODS: A small-scale convergent-parallel mixed methods study design consisting of observations with focus group interviews (FGIs) by using the Systems Engineering Initiative for Patient Safety model (SEIPS). The study was conducted at two Norwegian municipal nursing homes in Oslo for two weeks in January-February 2023. FINDINGS: Out of 73 observations, gloves were used in 67 episodes, not worn even if indicated in six observations, and were overused 16 times (21.9%). Lack of hand hygiene after glove removal was observed in 36 out of 67 instances (53.7%). Two FGIs disclosed that glove usage decisions are shaped by habits, knowledge, experience, and emotions linked to patient requirements, tasks, and glove type. Double gloves were used for self-protection and efficiency. Availability of gloves was a facilitator, while poor glove quality posed a barrier. CONCLUSION: Despite HCWs' knowledge of glove guidelines, their attitudes did not consistently ensure compliance. This study underscores the need for targeted interventions to improve hand hygiene after glove removal, urging awareness of glove overuse to reduce infections, protect HCWs' skin, and promote sustainability.

Hospital nurses and home care providers' experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study.

BACKGROUND: A person-centred approach to nutritional care has the potential to increase an older person's role in making informed decisions about their own care and possibly improving their quality of life. However, despite the considerable interest shown in person-centred nutritional care in recent years, delivery of such care still appears to lack consideration for older persons' needs and preferences. The present study aimed to explore healthcare professionals' views on how older persons and their family caregivers participate in decisions about their own nutritional care and possible barriers for that participation. METHODS: Semi-structured in-depth interviews with 23 healthcare professionals in acute geriatric care and home care were conducted. Data were analysed thematically. RESULTS: The analysis of the interviews resulted in three main themes: (i) lack of shared decision-making in nutritional care; (ii) conflict between patient's preferences and standard nutritional care procedures; and (iii) the value of family caregivers who are seldom involved in nutritional care. CONCLUSIONS: Healthcare professionals were aware of the importance of actively engaging older persons and their family members in the nutritional care to achieve positive outcomes. However, they encountered individual and structural barriers, including resistance from patients and family caregivers, conflicts between the patients' nutritional wishes and standard nutritional procedures, a wish to shield the family caregivers from the stress of caring for a sick relative, and lack of time and caring structures that facilitate the older persons and their family's active participation.