ICT sat down with Brian R. Palmer, product manager for gloves at Medline Industries, Inc., to discuss pertinent issues relating to the role that glove usage plays in infection prevention and control efforts.
Q: How does the proper usage of gloves protect healthcare workers and patients?
A: Proper use and selection of exam gloves is vital to protecting healthcare workers and patients.
Exam gloves protect healthcare workers against potentially infectious materials, such as blood and body fluids, or harsh chemicals. The protection offered by a glove, referred to as its barrier effectiveness, is the ability of the glove to withstand viral penetration. Gloves that pass Viral Penetration Tests (ASTM1671D) provide an effective barrier against bloodborne pathogens, as mandated by the Food and Drug Administration (FDA), the Cenetrs for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH). However, it is important to note that the use of gloves alone is not enough to provide the protection needed. Glove use does not eliminate the need for proper handwashing. In order to minimize the potential for infectious organisms to be spread throughout the facility, hand hygiene policies should include effective practices for both glove use and handwashing.
It is also important to select the proper type of exam glove for each type of use. While all Medline gloves pass Viral Penetration Tests (ASTM1671D), gloves only maintain effective barrier protection as long as they are intact. Traditional vinyl gloves have a tensile strength of about 11 MPa and are adequate for most routine nursing procedures. Newer second- and third-generation vinyl gloves are softer and stronger, with a tensile strength of 13-15 MPa. These gloves are an excellent general-purpose option. Latex and nitrile gloves are even more durable, with tensile strength typically in the range of 17 to 28 MPa and are recommended in applications where gloves are worn for a longer period of time or exposed to greater stress. Nitrile gloves also have chemical barrier properties that give them an advantage when handling certain drugs or chemicals.
Q: Why is gloves usage such an important component of personal protective equipment in the hospital environment?
A: Gloves are an important component of personal protective equipment especially considering how often healthcare workers’ hands are coming into contact with potentially infectious materials. Selecting the correct glove for use and incorporating proper hand hygiene compliance minimizes the risk of exposure to infectious material as well as decreases the risk of spreading infection throughout the facility.
Q: How can gloves facilitate infection control by addressing contact dermatitis and other skinintegrity issues?
A: Most hospital-acquired infections (HAIs) are transmitted from patient to patient via the hands of healthcare workers. (Source: Larson E. A causal link between handwashing and risk of infection? Examination of the evidence. Infect Control Hosp Epidemiol 1988;9:28-36.)
Proper handwashing is the most effective way to reduce the incidence of HAIs. (Source: Pittet D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000;21:381-386.)
According to published clinical studies, the No. 1 reason healthcare workers do not follow their facility’s hand hygiene protocol is dryness and irritation. As a result, the CDC strongly recommends the regular use of products to prevent and treat dryness and irritation.
Medline’s Aloetouch® gloves have been shown to moisturize and soothe dry, chapped hands. When these conditions are improved, our customers tell us hand hygiene compliance rates increase. The clinical rationale behind this is outlined below:
1. Dr. Elaine Larson of Columbia University, AJIC 1995 Dr. Elaine Larson conducted a monumental study indicating that skin irritation and dryness were the leading deterrents to handwashing. This study led to the famous CDC recommendation for the “regular use of products to prevent and treat irritant contact dermatitis caused by hand hygiene products.” (Source: Larson E, Kretzer EK. Compliance with handwashing and barrier precautions. J Hospital Infection; Vol. 30, 1995. Page 88-106.)
2. Dr. Dennis West of Northwestern University, AJIC 2003 Dr. Dennis West conducted a study comparing the skin integrity of affected dry and irritated skin study participants before and after the introduction of Aloetouch exam gloves. Study participants wore an aloe glove on one hand for 30 days and left their opposite hand gloveless for 30 days. The study concluded that the mean time to the first noticeable improvement for the aloe glove hand was 3.5 days and the mean time to significant improvement in skin quality was 10.4 days. There was no improvement witnessed in the non-glove hand for any of the participants. The study also indicates that after the aloe glove was removed, the dry and irritated skin of the study participants returned. (Source: West D, Zhu YF. Evaluation of aloe vera gel gloves in the treatment of dry skin associated with occupational exposure,” Am J Infection Control; 2003, Vol. 31, page 40-42.)
3. Dr. Dennis Maki of University of Wisconsin, AJIC 2000 Dr. Dennis Maki conducted a study for the American Journal of Infection Control in 2000 where an experimental group of healthcare employee study participants used a moisturizing hand lotion to improve skin quality while a control group continued normal activities. The study concluded that hand hygiene compliance improved more than 50 percent over the control group that did not use the lotion. (Source: McCormick R, Buchman T, Maki D. Double-blind randomized trial of scheduled use of a novel barrier cream and an oil-containing lotion for protecting the hands of healthcare workers. Am J Infection Control; 2000, Vol. 28, Page 302 -310.)