Conclusions
This cluster randomized clinical trial demonstrated that a policy endorsing a direct-gloving strategy led to improved adherence with expected practices and increased overall glove use, was accepted by HCP, and was as safe as the current strategy requiring hand hygiene before donning gloves in areas in which hand hygiene rates were otherwise high. However, a direct-gloving strategy should not be used in the ED or in other areas in which overall adherence to hand hygiene and glove use is low until further studies have been completed.