>> Welcome back everyone to Inside Infection Control, our video blog here from CDC's Project Firstline. I'm Abby Carlson. It's great to have you here today. We are going to talk today again about PPE. And this time we're going to cover gloves. Why are gloves part of the recommended PPE for COVID-19 and for other diseases? What do they do? Well, using gloves, as you might think, protects you from getting things on your hands, germs, but it also protects you from spreading those germs and the other stuff you get on your hands around your environment and to other patients. So how does that happen? We talked about how germs spread from surfaces to people and people to surfaces in a different vlog episode. And we'll just say quickly that this kind of spread, which we call contact transmission, is important for many diseases and many germs that we worry about in healthcare, so things like C. difficile, MRSA, VRE. It's not just about COVID-19. But COVID-19, even though it mainly spreads by respiratory droplets, there is also some transmission or spread by touch that can happen, and we need to protect from that as well. So how do gloves prevent the spread of germs? Well, healthy skin actually is a fantastic barrier to infection. Germs don't go through your skin, for the most part. Very few actually infect your skin directly unless the skin is damaged in some way. So if you touch something in your daily life, most of the time nothing happens. But if you have small cracks or wounds or breaks in your skin, germs can get through those potentially, say if you accidentally touch a body fluid that has a germ in it, and then it can make you sick or cause problems with your skin. Germs can also spread from that broken skin to other people and so gloves are important for this part of protecting skin. It's really to protect the small cracks, even ones you can't see, and wounds on your hands from getting contaminated or from things that are on your hands that might be spread to other people from your wounds. All right. So this is one of the reasons we wear gloves. But there is a second reason and this is the bigger reason in healthcare infections. It helps prevent the spread of germs from place to place or from person to person that we carry about on our hands. When you're wearing gloves, if you touch something that has stuff on it like germs or body fluids, that stuff gets on your gloves. And then if you touch something with your gloved hand, that stuff can spread to whatever you touch. So if you go place to place in your healthcare facility and you're wearing the same pair of gloves, then you're possibly spreading virus or other germs from one person to the next to the next to the next. It's as if you didn't wash your hands or clean your hands between patients. But if you remove those gloves correctly between patients or between tasks, then germs can't spread that way. That's why when you do that, when you move between these patients and tasks, you take those gloves off and you put clean ones on so that you remove whatever's on them. And then of course between that, before you put that new pair on and after you've taken the old one off, you clean your hands. But why? Why should you clean your hands after you've just taken a gloves off? Your hands were already clean, right? Unfortunately, that's not how it works. So of course there is the possibility that you didn't remove your gloves quite the right way and like you accidentally touch the outside of one, then your hands are dirty with whatever was on the outside of the glove and they need to be cleaned. But we've looked at this. We've looked at germs on hands and seen even if people are taking their gloves off perfectly correctly, there are still germs on those hands. Those hands are still dirty. You just don't know it because you can't see it and so it's really important to clean your hands after you remove your gloves whether you think they've gotten dirty or not. We just talked about taking gloves off. What about putting them on? Well, you have to clean your hands before you put those gloves on too and before you even reach in the box. Any of us who have worked in healthcare, we know that when you put your hand into that box, it's not as simple as just pulling out one glove. You have to pull that glove apart from all the other gloves in the box, and you might have to pull a few around and make it come out nice and that means you're handling all the gloves in the box. But even if you're just handling your own, even if it just comes out nice and straight, that's still -- anything on your hands that gets onto that nice clean glove that you're about to put on. So if you reach in with dirty hands, all those gloves get dirty. If you clean your hands beforehand, all of those gloves will be cleaner and you won't contaminate or get dirty everything in the box. All right. With that, we want to cover one more topic, double gloving or wearing more than one pair of gloves at the same time. This is not a part of routine care. It's only used in very specific situations in healthcare, and the list is small. When you wear more than one pair of gloves, new risks come that you may not think about. For example, you end up being a little bit more clumsy with your fingers and you can't feel things on your fingertips. Anybody who's tried to do small procedures like hooking up an IV or inserting a needle into something knows that this can cause problems. It makes those things a little bit more difficult to do so that's one issue. But also, we're in a situation where we're facing a lot of shortages and using more gloves than you need makes those shortages worse and so there may not be gloves for other situations where they're really needed. Finally, this is a way that germs, other germs can spread and this isn't a maybe situation. When you put on more than one glove and then you remove the top layer between patients but you keep those bottom layers on, you're increasing the risk that bottom glove is going to get dirty or contaminated. And that bottom layer, when it gets contaminated, can start spreading things between patients, spreading things back to the top glove. It gets really, really problematic really fast. So it might seem like this is something that is rare or wouldn't often cause problems but, in fact, we recently had an outbreak of a fungus called Candida auris or C. auris in a hospital's COVID-19 unit and that was partially because of this practice of double gloving when you didn't need to. We're going to link to that article so you can read about it yourself. It's going to be on our comments on the Facebook page so take a look there and see what happened and why. So you see why it's important to use your gloves right, the right way, at the right time, and to keep your hands clean in-between. This helps stop the spread of infections in the healthcare setting not just for COVID-19 but for many different diseases. Wear them correctly. Put them on correctly. Take them off correctly. Wash your hands when you need to and you'll help protect your patients every day. Thanks once again for joining us here. As always, please be sure to follow up with us at Facebook and Twitter. And we have some of our videos up on the CDC's YouTube channel right now so check us out there. As always, too, you can find us on the web cdc.gov/projectfirstline. We'll see you all with the next episode.