Reducing inappropriate non-sterile glove use in an acute NHS trust: A quality improvement evaluation of the Gloves Off campaign

Abstract

Background Inappropriate glove use can undermine hand hygiene, increase cross-transmission risk, and contribute to healthcare waste. Objectives To evaluate a trust-wide quality improvement campaign aimed at reducing unnecessary non-sterile glove use and improving appropriateness of glove use. Methods A multimodal intervention was implemented across an acute NHS Trust (February 2023–April 2026), including education, policy refinement, visual prompts, and audit feedback. Evaluation used a triangulated design: staff survey, statistical process control (SPC) analysis, and procurement/environmental trend data. The Capability, Opportunity, Motivation and Behaviour (COM-B) model informed interpretation. Descriptive statistics and SPC methods were applied. Results A total of 123 staff responded. Mean knowledge score was 89%, with 76% scoring ≥80%; 72% reported receiving education and 75% exposure to campaign materials. Confidence was high (95.1%), but fewer (65.9%) felt comfortable challenging inappropriate practice. SPC analysis showed common-cause variation with no sustained improvement in glove use audit data. Procurement data suggested an initial reduction followed by plateau: glove use decreased from 57.24 to 49.52 per occupied bed day (difference 7.71). Waste and carbon metrics showed similar proportional reductions (∼13.5%). Due to mixed reporting periods, findings are interpreted as trend data. Discussion The campaign achieved high knowledge and early system-level reductions but did not produce sustained behavioural change. Significance and impact Findings suggest a ceiling effect, with residual behaviour driven by social and contextual factors. Future efforts should prioritise targeted, behaviour-focused interventions over repeated trust-wide awareness campaigns.