Sustainable Non-Sterile Glove Use for Injections: A Scoping Review of Practices, Attitudes, and Behavioural Drivers

Abstract Background Inappropriate non-sterile glove use presents patient and healthcare worker safety risks and contributes to healthcare waste and emissions. Existing guidelines suggest gloves are not routinely required for intramuscular and subcutaneous injections however practices may vary. This review aims to describe the practices and attitudes of nurses and midwives regarding glove use during injections. Methods A scoping review was conducted in accordance with Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Bibliographic databases (MEDLINE and CINAHL), Google Scholar and expert-identified grey literature were searched. Data extracted included evidence type, setting and location, glove use practices and attitudes, and information on related concepts including hand hygiene, risk assessment, sharps safety, and sustainability. Data were synthesised and mapped to the Capability-Opportunity-Motivation-Behaviour framework. Results A total of 31 articles from 9 countries were eligible and included primary research, clinical guidelines, educational resources and editorials. Research demonstrated substantial practice variation and provided evidence that glove use during injections contributed to poorer hand hygiene and cross-contamination. Guidelines stated that gloves were not routinely required, while educational resources presented mixed messages. Identified behavioural drivers of glove use were an understanding of infection prevention principles (capability), social and professional context (opportunity), and perceived safety (motivation). Conclusion Practice variation is common and may arise from misalignment between policy, education, and professional attitudes. Understanding behavioural drivers can inform the development of clear and consistent resources to support sustainable and safe glove use for injections based on risk assessment.