Using a basic life support stress-test to assess the influence of ethanol-based hand rubs nitril gloves and of physically demanding clinical tasks on personal protective equipment fit (GLOVDIS-1) - a pilot Manikin study.

Abstract

Aim: Hand hygiene and personal protective equipment (PPE) are essential components for infection control. However, existing data are inconclusive regarding the impact of ethanol-based hand rubs on glove integrity, and evidence is limited on whether individual PPE components maintain adequate fit and usability during physically demanding clinical tasks. This pilot study aimed to evaluate the feasibility of a simulation-based protocol, designed to investigate hygiene- and PPE-related benefits and limitations under realistic emergency conditions.

Methods: In a prospective observational study, 60 health care workers (HCW) pairwise performed two cycles of cardiopulmonary resuscitation (CPR) according to Basic Life Support standards while wearing full personal protective equipment. Participants were double-gloved; outer gloves were disinfected with an ethanol-based hand rub (EBHR), while the inner gloves remained native. Glove integrity was assessed according to DIN EN 455-1, and subjective PPE fit was rated before and after CPR. Feasibility, glove leakage, and changes in PPE fit were analyzed descriptively and exploratorily.

Results: The study protocol proved feasible, with no dropouts and successful integrity testing of 478 out of 480 gloves. Glove leakage occurred in 3.8% of gloves, with no significant difference between disinfected and native gloves. Subjective PPE fit remained unchanged for gloves, respirators, and eye protective devices, whereas gown fit deteriorated significantly after CPR.

Conclusion: This pilot study demonstrates the feasibility of a standardized simulation-based Basic Life Support stress test to investigate the influence of glove disinfection with two different EBHRs on PPE performance under simulated emergency conditions. Ethanol-based glove disinfection did not increase glove leakage, whereas gown fit deteriorated during CPR. Larger, adequately powered studies may base on these results to further evaluate PPE performance and inform evidence-based infection prevention strategies in emergency care.