Infection prevention
take into account the AQL, tensile strength, packaging and dispensing of the gloves, as well as the type of mechanism used to carry out this dispensing.
Drivers and consequences for the overuse of gloves There is a chronic over-use of gloves by healthcare providers. This is partially driven by the COVID-19 pandemic, where national recommendations were, at one stage of the pandemic, for glove use for all direct patient care. Even before the pandemic though, over-use of gloves was a recognised issue. The key drivers for the over-use of gloves are as follows: l Glove use provides a false sense of security to staff, who feel protected and don’t then do hand hygiene when the gloves are removed.8
l Gloves tend to be worn for too long, way beyond the duration of the immediate task
for which they were selected.9
l Patients often feel uncomfortable with inappropriate use of gloves for personal tasks.5
l Gloves add to the huge volume of plastic waste produced by hospitals.
l Gloves can be expensive, and while the unit cost of each pair is relatively small, the overall cost burden to an organisation is large.
l Gloves cause and exacerbate skin issues for staff. For example, a Royal College of Nursing (RCN) survey of 1531 members found that 46% rated the condition of their hands as ‘poor’ or ‘very poor’, 23% had a clinical diagnosis of hand dermatitis, and 2% of staff were off sick due to severe hand dermatitis. The most common self- reported causes of hand dermatitis were glove and soap usage, excessive hand hygiene actions, including alcohol hand gel use.
These factors have prompted several organisations to develop “gloves off” campaigns to promote the best practice use of gloves.
Glove quality and risk of occupational exposure: considering minor procedures, EPP, and HCID Choosing appropriate gloves is especially important in three areas: minor procedures not always requiring sterile gloves (such as urinary catheter insertion and management, wound care, and minor surgical procedures), exposure prone procedures (EPP), and High Consequences Infectious Diseases (HCID). While there is broad consensus in the literature for some occasions when sterile gloves should be worn, such as major surgery under general anaesthetic, there is disagreement in the literature as to when non-sterile gloves could be worn for minimally invasive procedures.9 There is also disagreement in the literature about whether sterile gloves are required for urinary and vascular catheter insertion and management, and wound care. In these settings, the availability of a higher quality non-sterile glove would provide an intermediate option between traditional non-sterile gloves and sterile gloves. EPP are defined as those procedures where the healthcare providers gloved hands may be in contact with sharp objects (such as needles or sharp tissues like bone or teeth) inside a patient’s open body cavity or wound, where the hands or fingertips may not be completely visible at all times. A sharps injury to the healthcare worker undertaking an EPP may result in the patient being contaminated with the blood of the healthcare worker, with risk of infection. In this scenario, the quality of the glove being used
42
www.clinicalservicesjournal.com I November 2024
peterschreiber.media -
stock.adobe.com
James Thew -
stock.adobe.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80
