IDWeek 2026: ICU Study Finds Lower Glove Bioburden With PostCare Alcohol Application

Applying alcohol-based hand rub (ABHR) to gloves after patient care significantly reduced bacterial bioburden in a study conducted across 3 surgical intensive care units (ICUs). Applying it before care did not produce a statistically significant difference compared with standard practice. Staff feedback also identified an implementation challenge: Confidence in the practice did not necessarily translate into perceived feasibility during high-acuity care.

The findings were presented at IDWeek in Washington, DC, in the poster “Impact of alcohol-based hand rub on the bacterial bio-burden of gloves used during direct patient care.” Researchers evaluated both microbiological outcomes and staff attitudes at Carilion Roanoke Memorial Hospital, a 708-bed academic medical center.

The authors emphasized that the practice should not be viewed as a substitute for established measures. “Postcare ABHR on gloves may add a layer of protection but does not replace glove changes or hand hygiene,” they concluded.

Median counts were 5.0 CFU vs 172.5 CFU with standard practice, with a P value of less than 0.001. Precare application showed no statistically significant difference.

The study’s primary objective was to assess the impact of ABHR on bacterial bioburden on gloves used during direct patient care. A secondary objective examined ICU health care professionals’ attitudes toward using ABHR on gloved hands.

The poster describes frequent glove changes as a challenge in ICU practice. It also cites prior research reporting reduced bacterial contamination and improved workflow with ABHR applied to gloved hands. However, the effectiveness and acceptability of the practice in a high-acuity ICU setting remained unknown.

The microbiological component included 110 valid samples across 4 study arms. In the standard-practice arm, staff donned gloves, performed a patient care activity, and then had the gloves swabbed.

Two intervention arms involved applying ABHR before the patient care activity. One used a stationary dispenser, while the other used a portable dispenser. Gloves were swabbed after care in both groups.

The fourth arm evaluated application after patient care. Staff donned gloves and completed the care activity before applying ABHR. Swabbing followed the application. The laboratory process used MC-Media Pads with automated colony counting.

Postcare Application Produced Different Results

Median colony-forming unit (CFU) counts did not differ significantly among standard practice and the 2 groups receiving ABHR before care. The median was 172.5 CFU in the standard-practice arm, compared with 126.0 CFU in the stationary-dispenser arm and 266.5 CFU in the portable-dispenser arm. The reported P value was 0.691.

Results differed when ABHR was applied after patient care. That arm had a median bioburden of 5.0 CFU, significantly lower than the standard practice, with a P-value of less than 0.001.

The authors summarized the timing distinction directly: “Applying ABHR to gloves after patient care, not before, reduces bioburden.” The reported microbiological outcome was bacterial contamination on gloves; the poster did not report a reduction in patient infections.

Staff Confidence Did Not Resolve Workflow Concerns

The human factors component used a 10-item Likert-type REDCap survey with 22 ICU staff members. It explored confidence in the efficacy and safety of gloved-hand sanitization, along with its practicality during high-acuity care. Questions also addressed workflow integration and the effects of dispenser design.

Among respondents, 72.73% reported confidence in using ABHR on gloves. Separately, 66.67% believed that bedside placement of ABHR dispensers enhances compliance. These responses indicated support for aspects of the practice, but concerns about its use during demanding care remained.

Specifically, 63.64% did not agree that applying ABHR to gloved hands was feasible during high-acuity care. Dispenser preference was also evident: 86.36% preferred stationary ABHR dispensers to portable ones for hand hygiene during patient care.

The authors noted that staff favored stationary bedside dispensers over wearable devices, which they found disruptive to care. This finding placed equipment design alongside microbiological effectiveness as an important consideration.

Effectiveness and Feasibility Must Be Considered Together

“Effectiveness alone will not drive uptake,” the researchers wrote. They concluded that concerns about high-acuity care show the practice must fit existing workflows rather than add to them.

The study, therefore, identified both a microbiological benefit from post-care application and practical barriers to implementation. Its conclusions retain a clear boundary: Any potential additional protection from ABHR on gloves does not replace glove changes or hand hygiene.

Poster authors: Maimuna Jatta, MSN, RN, CIC, CPHQ, FAPIC; Ellen Harvey, DNP, APRN, ACNS-BC, CCRN, TCRN, SCRN, FNCS, FCCM, FAAN; Jayasima Rao, PhD; Ruth Ndolo, EdD, RN, PMP; Brian Loftus, BSc; Tonja Locklear, PhD; Emmanuel Tetteh, PhD; and Anthony Baffoe-Bonnie, MD, FIDSA.

Study setting: Carilion Roanoke Memorial Hospital, Carilion Clinic.

Support disclosed on the poster: The research received a Carilion Clinic Research Acceleration Program grant. Ecolab provided the alcohol-based hand rub, and Keyence provided the automated colony counter on a trial basis.