Proper surgical gloving techniques can not only save a hospital valuable time and money, they also benefit both patients and clinicians, according to Dana Weaver, RN, BSN, MHA.
The most common gloving mistake I saw during my clinical experience was clinicians not knowing whether or not a patient was allergic to latex. This mistake occurs for a number of reasons. For example, maybe the patient wasn’t screened properly prior to being brought into the operating room. Let’s consider a scenario: A patient misses their pre-admission testing visit and, on the day of the surgery, one of the clinicians — perhaps a scrub tech — opens the operating room wearing latex gloves. This clinician will touch the instrument trays, the drapes, the gowns etc., only to find out that the patient shared they have a latex allergy during their pre-op interview on the morning of the procedure. Upon learning of the allergy, the OR has to be broken down and set up again, instruments must be resterilized, etc., causing a delay that could affect the whole OR schedule for the day.
The best-practice approach of using synthetic surgical gloves could help to avoid a scenario like this and help a facility prevent costly OR teardowns and idle OR time.
Double-gloving — or wearing two surgical gloves — significantly reduces infection risk for operating room personnel.4 For a relatively low cost, double-gloving helps provide a high level of protection. One study shows that the interior glove reduces exposure to patient blood by as much as 87 percent when the outer glove is punctured.5 Wearing a colored underglove, which contrasts visually with the color of the outer gloves, can also help improve occupational safety by increasing awareness of perforations to the outer glove.6 Clinicians wearing a colored bottom glove can more quickly identify a sharps breach and minimize exposure time.
Double-gloving is recommended for invasive surgeries by many organizations, the Centers for Disease Control and Prevention (CDC)7, the Occupational Safety and Health Administration (OSHA)8, as well as the American College of Surgeons (ACS)9 and AORN.10
Before beginning a procedure, care should be taken to select the right surgical gloves. According to the Association of periOperative Registered Nurses’ Recommended Practices Guideline for Sterile Technique, gloves used in the perioperative setting should be evaluated and selected for safety, efficacy and cost before use. Many factors should be considered including:
Evaluating the following glove selection criteria through staff trials will help clinicians choose the best surgical gloves for their needs:
2 AORN 2015 Guidelines for Perioperative Practice: Guidelines For A Safe Environment Of Care, Part 1. Recommendation VIII.a. Pg 251.
3 American College of Allergy, Asthma and Immunology; American Academy of Allergy, Asthma and Immunology: “AAAAI and ACAAI joint statement concerning the use of powdered and non-powdered natural rubber latex gloves,” Annals of Allergy, Asthma, and Immunology Vol. 79, Issue 6, Page 487 (December 1997)
4 Tanner, J., Parkinson, H., Double gloving to reduce surgical cross-infection, Cochrane Database Syst Rev. July 2006
5 Berguer R, Heller PJ. Preventing sharps injuries in the operating room. Journal of the American College of Surgeons. 2004;199(3):462- 467.
6 Florman S, Burgdof M, Finigan K, Slakey D, Hewitt R, Nichols RL. Efficacy of double gloving with an intrinsic indicator system. Surg Infect (Larchmt). 2005;6(4):385-395.
7 Centers for Disease Control and Prevention. Guideline for prevention of surgical site infection, 1999. Infection Control and Hospital Epidemiology, April 1999, 20(4):247-278. http://www.cdc.gov/hicpac/pdf/ssiguidelines.pdf
8 Bloodborne pathogens standard. 29 CFR 1910.1030. US Department of Labor – Occupational Safety and Health Administration. https://osha.gov/pls/oshaweb/owadisp.show_document?p_table=PREAMBLES&p_id=801
9 “Statement on Sharps Safety.” American College of Surgeons. October 2007. https://www.facs.org/about-acs/statements/58-sharpssafety
10 AORN Guideline for Sterile Technique from 2015 Guidelines for Perioperative Practice.
11 GHX Data 2013 – 2016 – All channels