Blog by Hayley Reid, senior quality improvement advisor

The 5th of May marks World Hand Hygiene Day, initiated by the World Health Organization (WHO) in 2009 as part of the SAVE LIVES: Clean Your Hands campaign. This global initiative provides a platform for hospitals, care homes, social care services, and early learning and childcare (ELC) settings to raise awareness and take meaningful action to improve hand hygiene practices. 

World Hand Hygiene Day offers us an opportunity to pause and reflect on observed practice trends, audit findings, and the environmental and cultural challenges that influence how effectively hand hygiene is performed across care settings.

Reflections from practice across systems 

In my role as a senior quality improvement advisor within the Care Inspectorate, with a specialist focus on Infection Prevention and Control (IPC), alongside my continuing role as an IPC nurse in NHS acute services, I am uniquely positioned to observe practice across very different care environments. 

While acute and social care settings differ significantly in structure, pace and resources, there are striking similarities in practice trends, behavioural challenges and risk perceptions—particularly in relation to glove use and missed hand hygiene opportunities. 

The overuse of gloves: a legacy of the pandemic 

The Covid‑19 pandemic has left a lasting “PPE hangover” across health and social care. Frequent changes in guidance, combined with fear of transmission, have resulted in confusion around the principles of Standard Infection Control Precautions (SICPs) and Transmission‑Based Precautions (TBPs). One clear outcome has been the widespread overuse of non‑sterile gloves across all care settings. 

Commonly observed trends include:

  • gloves worn when not clinically indicated
  • gloves donned too early
  • failure to remove gloves at critical points
  • gloves used for multiple tasks 
  • missed hand hygiene opportunities 

Rather than reducing risk, these practices can increase environmental contamination, facilitating the transfer of microorganisms via surfaces, equipment and hands—ultimately leading to cross‑contamination and avoidable harm. 

Evidence also highlights that glove‑wearing decisions are often driven not by risk assessment, but by emotional responses such as fear and disgust, alongside assumptions about patient expectations and perceived social norms within teams.

But what does this mean for the people we care for? 

People receiving care and support have reported discomfort and distress when gloves are used during non‑clinical, personal interactions such as dressing, mobility support or reassurance. 

Touch plays a vital role in compassionate, person‑led care. Gentle, appropriate skin‑to‑skin contact communicates safety, presence and respect—particularly when individuals feel vulnerable, anxious or unwell. Research demonstrates that hand‑holding activates neural pathways associated with emotional regulation and stimulates oxytocin release, helping to reduce pain perception and stress. 

Human touch also supports trust, rapport and connection, reinforcing that people are seen as individuals rather than tasks. This aligns directly with person‑led care, safeguarding dignity in every interaction. 

Simple interventions such as hand massage have been shown to reduce anxiety, pain and agitation while promoting calmness and wellbeing. These meaningful care moments are easily lost when gloves are over‑used without critical reflection. 

Back to basics: hand hygiene matters 

Hand hygiene remains the single most effective measure to prevent the transmission of harmful microorganisms, protecting both staff and those receiving care. 

High‑quality hand hygiene practice relies on two core components: 

The four moments of hand hygiene 

  • Before resident/person contact
  • Before aseptic procedures
  • After body fluid exposure risk
  • After resident/person contact 

Effective hand‑washing technique 

Gloves are not a substitute for hand hygiene.

Clean hands—used appropriately and consciously—are safer, kinder and more effective. 

A call to action for World Hand Hygiene Day 

This World Hand Hygiene Day, let us: 

  • reflect critically on why we use gloves 
  • re‑embed risk‑based decision‑making 
  • champion bare below the elbows and clean hands 
  • normalise human touch where it is safe and appropriate 
  • create environments where staff feel confident, supported and informed 

By choosing hands over gloves when gloves are not indicated, we protect safety and preserve humanity in care. 

Clean hands save lives—but compassionate hands build trust. 

My challenge to you 

Let’s get back to human touch. 

Offer someone—with permission—a five‑minute hand massage.

It could be a colleague, patient, resident or service user. 

Observe the benefits—for them and for you. 

Use the hand massage techniques suitable for your setting, or refer to the Royal Marsden self‑care guide.

Remember: 

  • your four moments of hand hygiene 
  • your 12 steps to hand washing.