Jordan Flatt
Pros and Cons of Double-Gloving
In the health care profession, one of the most important things for physicians and nurses is to avoid being infected by bacteria and viruses from sick patients. Proper use of the correct PPE is one of the keys to ensuring the protection of health care workers. Among other PPE including scrubs, respirators, and eye protection, gloves are very important for the control of disease. However, there is much dissention among physicians about the use of single or double gloving. Different studies have examined the pros and cons of single gloving compared with double gloving, and the impact that each has in the field of medicine.
The first study examined the spread of virus from a physician’s clothing to their hands following the de-gowning process. Test subjects were asked to gown out in full PPE, just as they would if they were examining an infected patient. The doctors were then “contaminated” with bacteriophage on various places of their PPE. The goal was then to de-gown while minimizing the amount of virus that was transferred to his/her hands. Their hands were then tested for viral contamination. As was expected, the results showed that significantly more virus contamination was seen on the hands of the test subjects following the single gloving test than was observed following the double gloving test. Additionally, less virus was transferred to the other PPE when doubling gloving was used. This was true for all parts of the PPE tested, aside from the few examples of improper de-gowning techniques. This lead to the conclusion the in order to provide the best protection from viral transfer, double gloving is more effective than the more common single gloving. Additionally, it was determin...
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...ouble glove, but several reasons why doctors should.
Casanova L, Rutala W, Weber D, Sobsey M. Effect of single- versus double-gloving on virus transfer to health care workers’ skin and clothing during removal of personal protective equipment. American Journal of Infection Control. Vol 40. 369-74. 2012.
Florman S, Burgdorf M, Finigan K, Slakey D, Hewitt R, Nichols R. Efficacy of Double Gloving with an Intrinsic Indicator System. Surgical Infections. Vol 6. No 4. 2005
Fry D, Harris W, Kohnke E, Twomey C. Influence of Double-Gloving and Tactile Sensation of Surgeons. Journal of American College of Surgeons. Vol 210. No 3. 2010.
Guo Y, Wong P, Li Y, Or P. Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery. The American Journal of Surgery. Vol 204. 210-215. 2012.
One study evaluates the gloving procedure in the health care field in relation to virus transfer (Casanova, 2012). After the worldwide SARS outbreak, the CDC proposed a re-evaluation of PPE protocols to minimize patient exposure to infections. Casanova’s group states that CDC’s proposed protocol was “not empirically validated.” They suggest using model systems to develop this data. A previous study using a model system is cited and Casanova suggests alternatives to CDC’s protocol derived from the cited study. “One such alternative is double-gloving… When removing PPE, the outer pair of gloves is removed first, followed by the rest of the PPE items, and the inner pair of gloves is removed last” (Casanova, 2012). Casanova’s group used the model system to evaluate the viability of this double-gloving procedure. This study concluded that double-gloving does decrease the risk of disease transmission and suggests incorporating this into PPE procedures for health care workers.
Following the proper guidelines for reducing the risk of transmission of TSEs in a clinical setting, the risk has been greatly reduced. As mentioned before no iatrogenic transmission from a medical instrument has been recorded since 1976 since following the standard guidelines. In an experiment by Amin et al., they examined the risk of transmission of vCJD via contact tonometry. They outlined that transmission could be further reduced by using larger volumes of washes for extended periods of time and also adding wiping between washes (16). This could help in the future to completely eradicate TSE transmission completely by increasing sterilisation methods. Proper training on all aspects of transmission of TSEs through medical equipment and proper sterilisation methods should be updated just to keep staff up to date to prevent the risks of TSEs transmission.
It would not have been acceptable for the medical assisting extern to not wear gloves while cleaning the table. Gloves are needed to prevent contamination and the spread of infectious materials.
“The CDC is the primary developer of national infection control and prevention guidelines, often in collaboration with its Healthcare Infection Control Practices Advisory Committee, which is responsible for research and dissemination of the latest information for preventing disease transmission” (Griffis, 2013, p. 175). Infection control will continue to be a topic of discussion as long as germ transmission is still happening. Among these studies is the concern the frequent nonadherence to contact precautions is a huge issue that many studies are still very concerned about (Jessee & Mion, 2013, p. 966). The writer is also concerned with the blatant disregard for hand hygiene that appears to be happening in the medical field. What about what is best for the patient. Do the people that do not use proper hand hygiene not understand how important it
The Ebola virus can be passed from one person into another by bodily contact. Airborne transmission of Ebola has not yet been confirmed, as there is no substantial evidence of this occurring. Researchers are still to this day observing the ways of transmission of this virus from one person to the next. In previous outbreaks, this infection has often occurred among hospital care workers or family members who were caring for an ill or dead person infected with the virus. Blood and body fluids contain large amounts of virus, thus transmission of the virus has also occurred as a result of hypodermic needles being reused in the treatment of patients. Under-financed health care facilities in countries such as Zaire, Gabon, and Sudan find reusing needles a common practice. This contributes the vast amount of fatalities of this virus in these cities.
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
There can never be enough emphasis on its teaching in school, communities, colleges, hospitals, clinics etc. There are a lot of journal articles, books and research material available to support this easy prevention technique. Rachel Barrett and Jacqueline Randle (2008) in their journal, Hand hygiene practices: nursing students perceptions, state that “Hands of healthcare workers and patients are therefore a primary cause for the transmission of infections by both endogenous and exogenous spread” (Para. 1). This is a relevant point which must be highlighted in every study material and teaching plans by the tutors in healthcare settings. Without proper hand hygiene it not possible to decrease the ill effects of infections spread through contact. The authors further discuss that other standard precautions should be kept in mind as those are important too. For example, while doing dressing change or assessing the pressure ulcer it is crucial to wear gloves as hand washing alone would not be enough to protect from contamination. However, the main point to remember is that gloves should not be used as a substitute for hand
Recent research shows that, there are three major means by which infections can be transmitted and they include direct transmission, indirect transmission and airborne transmission (Hinman,Wasserheit and Kamb,1995). Direct transmission occurs when the physical contact between an infected person and s susceptible person takes place (division of public health, 2011). An example is a health care worker who attends to an Ebola patient, without gloves, gown and mask plus forget to wash his or her hand with soap and hot water and or a person having flu without the use of mask or washes his hand after sneezing easily passes the infection to the other through hand shake or surface touch, living the bacteria there for another vulnerable person to also touch if the surface is not disinfected with bleach. Studies makes it clear that, the spreads takes effect when disease-causing microorganisms pass from the infected person to the healthy person through direct physical contact such as touching of blood, body fluids, contact with oral secretion, bites kissing, contact with body lesions and even sexual contact. However, measles and chicken pox are said to be conditions spread by direct
Better infection control practices and hand washing techniques utilized by the general population help to reduce the incidences of easily avoidable conditions, such as impetigo caused by staphylococcal and streptococcal infections. It may be beneficial for public health departments to recommend teachers to teach students on how to properly wash hands and clean high contact fomites.
Health and Human Services. Pincock, T., Bernstein, P., Warthman, S. & Holst, E. (2012). Bundling Hand Hygiene interventions and measurement to decrease healthcare-associated infections. American Journal Of Infection Control, pp. 113-117.
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare
...s and hoses, control buttons, switches, hand pieces, and X-ray units (Collins). After every patient’s visit, the operatory is to be sterilized and disinfected. All areas that were that were not covered with a barrier, or if the barrier was compromised, must be wiped down with surface disinfectants similarly used in hospitals. OSHA requires disinfectants to be potent enough to fight against HIV and HBV infections (Collins). If there is any blood present on a surface, tuberculocidal type disinfectant should be utilized.
Although the importance of aseptic technique has been continually reiterated, I have realised its substantial role in the perioperative environment. Aseptic technique refers to the practice of creating and maintaining a sterile environment used for sterile procedures (Laws, 2010a). This is incredibly important as repetitive minor breaches of the sterile environment is one of the major factors increasing the risk of surgical site infection (Harrop et al., 2012).
Due to the fact that during a surgery you will be using your hands you must be very careful even if you are wearing safety equipment. Protective wear can help tremendously by eliminating any easy route of transmission of any viruses, or diseases etc. Through medical school it will be required that surgeons wear gear that will protect them. Always wear protective gear no matter how little the operation could be, surgeons will always be exposed to some kinds of bacteria which can be foreign to your own. According to Paul A. Ruggieri M.D.’s novel, “I love being a surgeon. I love being able to make a clear, tangible difference in the quality of a person’s life. Sometimes I even save a life. I am honored every time a patient comes to me, and I’m humbled at the trust that’s given.” Surgeons should have the same mindset as Dr. Ruggieri because making a difference in someone else 's life should be a huge priority. They should want to help someone with their problems. Surgeons leave a mark on other people’s life, and it should always be a positive one. The satisfaction knowing a surgery was performed on someone and treated their problems would feel