Infection prevention


reduce pathogen transmission if they are used appropriately and hygiene is performed timely, through hand rubbing or washing. In addition, safe glove use involves, donning gloves with a technique that prevents contamination and removing gloves with a technique that avoids contaminating hands. Unnecessary or inappropriate use of gloves wastes resources and may increase the risk of germ transmission. 3 Proper techniques for donning and doffing


gloves are fundamental to maintaining a sterile environment and preventing contamination. Operating theatre teams must adhere strictly to established protocols to minimise the risk of infection transmission.


Proper dispensing The method of dispensing and packaging gloves can reduce the risk of contamination. Using contaminated gloves, due to improper storage or incorrect techniques, and timing for donning and removing them can also lead to the transmission of germs. The correct way of donning and removing


gloves is extremely important for the safety of the patient and healthcare professional and to avoid cross-infections. According to WHO guidelines, gloves must be removed one by one from the packaging and only a restricted area of the glove corresponding to the wrist (at the top edge of the cuff) must be touched.3 Theatre teams must ensure that gloves are dispensed in a manner that minimises the risk of contamination. Proper glove dispensing involves maintaining the integrity of the packaging, ensuring it is intact and free from any damage, as tears or openings can lead to contamination. Hands-free dispensers that allow gloves to be accessed without touching multiple gloves at once are recommended. These can be wall- mounted or countertop dispensers presenting gloves one at a time. It is essential to place glove dispensers in clean, easily accessible areas, avoiding locations near waste bins or high-traffic areas where dust and debris are prevalent. When removing gloves from the dispenser, staff should use proper technique, touching only the cuff of the glove they are taking to reduce


the risk of contaminating the glove’s exterior. Regular inspection and replenishment of glove dispensers are crucial to ensure they remain clean and fully stocked, and any compromised packaging should be replaced. Therefore, it is very important that theatre


teams ensure that gloves are dispensed in a manner that minimises the risk of contamination by handling them correctly and maintaining the integrity of the packaging. By adhering to these practices, theatre teams can effectively reduce the risk of contamination and maintain a sterile environment.


Glove wastage and sustainability Since 1970, the ecological footprint has surpassed the Earth’s rate of regeneration, leading to irreversible climate change caused by greenhouse gas emissions. The healthcare sector contributes significantly to this ecological footprint, accounting for approximately 4.4% of global net greenhouse gas emissions.4


Consequently, health activities


must be increasingly viewed through the lens of sustainability and their environmental impacts. The healthcare sector, which includes the public health system, hospitals, primary health services and pharmaceutical companies, is a major contributor of harmful emissions and waste. Pollution resulting from healthcare activities has steadily increased over the years, largely attributed to the prevalent culture of disposable products and the generation of waste from improper use and manufacturing defects in equipment and materials. Healthcare causes global environmental impacts that, depending on which indicator is considered, range between 1% and 5% of total global impacts, and are more than 5% for some national impacts.5


Efforts to reduce


glove wastage and promote sustainability are increasingly important. Theatre teams should be mindful of glove usage, opting for appropriate sizes and minimising unnecessary changes to conserve resources and reduce environmental impact.


Medical facilities are the leading sectors of


environmental pollution and carbon emissions. If we are to envision a future where healthcare


facilities focus on both the patient and the planet, we must consider implementations to suit the current processes/procedures that are being carried out.6


Mitigating risks of needlestick/ sharps injuries Needlestick injuries (NSIs) are recognised as a major concern impacting the health and well- being of healthcare workers in most healthcare systems of developing countries. Implementing safety practices and other measures is essential to reduce the risk of NSIs.7


Needlestick injuries


are common in healthcare environments and can result in severe complications. Although the implementation of universal precautions and safer needle designs has reduced their incidence, these injuries continue to happen. Awareness about needlestick injuries began to grow shortly after the identification of HIV in the early 1980s. Needlestick and sharps injuries (NSIs) during


surgery can lead to serious occupational infections from blood-borne pathogens. These injuries cause significant mental distress, whether or not contamination is involved, and have been linked to depressive symptoms and post-traumatic stress. Furthermore, the average cost for each NSI is quite high for medical institutions, making prevention essential to reduce these expenses.8 Surgeons are more susceptible to blood- borne diseases compared to other healthcare workers, due to the high risk of needle stick injuries, and direct exposure to patients’ blood and body fluids. Surgeon’s hands are subjected to various chemical and physical stressors that can compromise glove integrity. Consequently, glove perforations can enable pathogen transmission through the resulting holes. Numerous studies have highlighted the significance of glove perforation, though there is still no full consensus on the matter.9 In a study done by Nicolai et al, comparing


the incidence of glove perforation, one or more perforations was detected in 14.6% of all gloves.10 In a more recent study, it was also concluded that the overall rate of glove perforation was 14.44%. Surgeons experienced the highest rate of perforations at 23.09%. Longer surgery durations


Above: When removing gloves from the dispenser, only the cuff should be touched, to avoid the risk of contamination. July 2024 I www.clinicalservicesjournal.com 39


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