Wednesday, March 28, 2012

The Positive Effects of Double Gloving- Revisited

Here is a paper on double gloving in the OR, published in AORN.


Source: Infection Control Today
The primary reason to double glove is to limit the risk of percutaneous injuries to operator, thereby reducing the risk of transmission of blood borne pathogens such as HIV, Hepatitis B and C.


Double gloving or double gloving with an indicator glove system may provide greater protection to the surgeon. During a 24 month survey, the investigators utilized a  comparative design to examine the effect of double gloving with inner indicator gloves on the durability of inner gloves and the detection of glove tears or perforations during surgery. The study was conducted in 2 major medical centers and a shock-trauma center. Twenty one surgical specialties were included and 8,723 pairs of double gloves were analyzed


The detection of blood on the hand after surgery was greater with single gloving (75%) than with double gloving (75% vs 25%) and the frequency of changing gloves during surgery was significantly higher among those who double gloved with an indicator glove system (70%) versus double gloving alone (59%). The majority of health care providers studied expressed favorable views about double gloving


In brief, double gloving results in fewer blood exposures and results in early detection of a perforated outer glove if a colored, indicator underglove is donned.


Of course, these finding are not all that new, but, they do add to the body of literature in support of double gloving as a safety measure. 


So why isn't uptake universal? Some surgeons are skeptical about practice changes and some have a disregard for evidence based practice. However, across healthcare systems, there are active resistors and organizational constipators blocking infection prevention and safety efforts. This is likely at play too.


 The evidence is mounting. Time to hop on the safety-wagon.

2 comments:

  1. I like the use of "Organizational Constipator" as descriptive of administrators blocking evidence based reform. Seems to echo a Freudian character type, described by Marcuse or Adorno, in the measure of authoritarian tendencies.

    And organizational health is certainly indicated by an appropriate input to output ratio...

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