Cochrane Review Briefs
Response by Gloria Thompson to “Cochrane Review Brief: Gloves, Extra Gloves or Special Types of Gloves for Preventing Percutaneous Exposure Injuries in Healthcare Personnel” by Alice S. Ashcraft (July 21, 2015)
Dear Editor,
Preventing the spread of infection is the ultimate goal of healthcare providers. Additionally, we must also ensure the safety of employees as they perform their duties. The recent OJIN column entitled, “ Cochrane Review Brief: Gloves, Extra Gloves or Special Types of Gloves preventing Percutaneous Exposure Injuries In Healthcare Personnel“ by Alice S. Ashcraft (2015), provides well-researched information on the effectiveness of double gloving in the operating room (OR). Medical teams in all operating rooms should adopt double gloving as a mandatory practice. It is also necessary to address the feasibility of double gloving when providing routine care to patients as it is also possible to come in contact with body fluids or non-intact skin in this situation.
The Occupational Safety and Health Administration (OSHA) has long ago made recommendations for the use of gloves and other personal protective equipment (PPE). In situations “when differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.”((Lack of) Universal Precautions, 1970, p. 1) If such is the case, and all body fluids may be regarded as infectious, then double gloving outside of the OR may prove just as effective.
When we take into consideration that nurses and intravenous (IV) technicians outside of the OR perform IV insertions and are thus also at high risk for needle sticks, double gloving should also be recommended in these situations. Perhaps, it should even be universally adopted as routine practice in the prevention of hospital-acquired infections. A report by the Center of Disease Control (CDC) comments on the difficulty in removing the spores of Clostridium-difficile (C-diff) once the hands are contaminated with this pathogen. The report recommends and emphasizes that the use of gloves is the most successful way to prevent the spread of infection by the hands of healthcare workers. Even washing hands with soap and water is not as effective against the removal of C-diff pathogens. ("Healthcare-associated infections", n.d., Question 9)
Finally, there are no guarantees concerning the integrity of gloves. Many gloves have slits and holes that are are not immediately discernable. Double gloving will prove to be effective by eliminating or reducing the amount of microorganisms that may accumulate on the hands, and in turn help to prevent the spread of challenging infections, such as C-diff.
Sincerely,
Gloria Thompson.
Senior Nursing Student
Medgar Evers College
New York, NY
References
Health-associated infections. (n.d.). Retrieved from http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_faqs_HCP.html#a8
(Lack of) universal precautions. (1970). Retrieved from https://www.osha.gov/SLTC/etools/hospital/hazards/univprec/univ.html
