The information and references for hand washing are all on the CDC web site where there are literally hundreds of published studies. Sterile gloves are only for caring of the unhealed exit site post operatively. There are no references that indicate a home dialysis patient should wear sterile gloves for exchanges. If the person performing the exchange donned sterile gloves they would be immediately contaminated by the outer surfaces of the tubing and transfer set. Only the inner portion of the tubing and transfer set are sterile of course. I recently encountered several nurses in the Seattle, Wash, area of the US who indicated the state health department insisted both patient and nurses wear non-sterile gloves to perform exchanges. This again is not documented by any published studies. Wearing non-sterile gloves could lead the wearer to believe that touching the sterile portions of the connection might be “OK”, thus leading to more touch contamination than for those relying upon handwashing and proper technique.