Nurses across Australia and the UK routinely snap on disposable gloves before preparing intravenous antibiotics. They have been taught this in nursing school. Hospital protocols demand it. There is just one problem: no scientific evidence supports the practice.
A comprehensive review from Edith Cowan University has revealed what researchers call a “critical gap” in healthcare guidelines. After scouring five databases and grey literature for studies published between 2009 and 2024, the team found exactly zero studies directly examining whether non-sterile gloves should be worn when preparing and administering IV antimicrobials.
“In fact, unnecessary glove use can be harmful,” said lead author Dr. Natasya Raja Azlan. “Staff are less likely to wash their hands, even though handwashing remains the best way to stop infections spreading.”
The implications ripple outward in unexpected directions. One NSW hospital that questioned its glove protocols discovered it could save $155,000 annually and cut 8 tonnes of medical waste simply by restricting glove use to situations where evidence actually supports them: contact with body fluids, mucous membranes, or genuinely hazardous medications.
The research team traced citations backward through decades of guidelines and policy documents, hoping to find the original evidence justifying glove use during IV antibiotic preparation. What they discovered instead was a citation chain leading nowhere. Guidelines cited other guidelines. Those cited expert opinion. Expert opinion referenced outdated practices from the HIV epidemic era, when universal precautions transformed healthcare.
Nursing textbooks instruct students to “wash your hands and put on gloves” before preparing IV medications. Educational videos demonstrate the same technique. Hospital standard operating procedures codify it. Yet none provide research evidence explaining why gloves improve outcomes for this specific task.
The review found that healthcare workers themselves often cannot articulate clear reasons for wearing gloves during IV antibiotic preparation. Interviews from included studies revealed that fear, disgust, and workplace socialization drive the behavior more than rational risk assessment. Some nurses worried about developing antibiotic allergies through skin contact, despite limited evidence this occurs through intact skin during routine preparation.
Healthcare product disposal generates 7% of Australia’s total carbon emissions, nearly matching the 10% from all road vehicles. Non-sterile gloves, typically made from latex, nitrile, or vinyl, do not biodegrade. Their production consumes fossil fuels and water. Disposal through incineration releases harmful chemicals. Landfilling allows microparticles and heavy metals to leach into water and soil.
Great Ormond Street Children’s Hospital in London cut glove orders by 3.7 million pairs after implementing an evidence-based educational program. The initiative saved more than £90,000 and reduced waste by 18 tonnes, with no increase in staff presenting to occupational health with skin problems and no rise in infection rates.
The financial burden extends beyond purchasing costs. Healthcare-associated infections, which incorrect glove use may facilitate by discouraging proper hand hygiene, drive up treatment expenses and extend hospital stays. Globally, 7 in every 100 patients in high-income countries acquire an infection during hospitalization. In low and middle-income countries, that number rises to 15 in 100.
“The disposal of healthcare products represents 7% of Australia’s national total carbon emissions, only slightly less than the 10% attributed to all road vehicles,” Dr. Lesley Andrew noted.
The scoping review authors found that guidelines from the WHO, CDC, and national health services agree on when gloves are indicated: anticipated contact with blood, body fluids, mucous membranes, broken skin, or genuinely hazardous chemicals. IV antibiotic preparation typically involves none of these exposures for the healthcare worker.
Dr. Carol Crevacore, a co-author and infection prevention expert, is now leading a collaboration across all Western Australian universities, TAFE institutions, and healthcare providers to re-evaluate nursing education. The goal is ensuring future nurses learn evidence-based practices rather than perpetuating rituals.
The research raises uncomfortable questions about how many other routine healthcare practices persist without supporting evidence. It also highlights the tension between precaution and proof in medical culture, where erring on the side of extra protection can seem safer than questioning established norms, even when those norms may cause unintended harm.
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