How to Select Gloves for the Right Task in the Healthcare Environment

How do I select the glove appropriate for the task?

For optimal protection and safety, glove materials should be chosen based on the tasks being performed and the healthcare professionals risk of exposure to bloodborne pathogens, potentially infectious materials, and chemical hazards in the workplace. For exam gloves, synthetic materials such as nitrile and neoprene may be better choices for chemical protection while vinyl is appropriate for less hazardous procedures and chemical exposure. Vinyl or PVC exam gloves can be an effective barrier protection glove when used for the right procedures. As described in APICs brochure, Glove Use for Healthcare Providers: Hand Covering and Barrier Protection, Vinyl synthetic examination gloves are appropriate for short-term tasks that involve minimal stress on the glove and low risk of exposure to blood and other potentially infectious materials. Consideration needs to be given to manipulation and other stresses placed on the glove material.

What are appropriate clinical uses for vinyl gloves?

Changing bed linen, administering an injection, starting D/C IV, brief suctioning, emptying emesis basin, managing urinary drainage bag, patient care <15 minutes, dressing change not saturated with blood or body fl uid, minor suture removal, clinical intervention <15 minutes, and low-risk patient-care units, such as ophthalmology, pediatrics, non-surgical clinics, employee health services.

What are some of the causes of glove failure, and how is the industry addressing these issues?

The primary cause of glove failure is inappropriate usage by the individual wearer. The risk of glove tears and punctures can be reduced by keeping fingernails trimmed and manicured, removing jewelry and selecting a correctly sized glove. Manufacturers such as Cardinal Health offer glove technical data as well as education in glove selection, sizing and appropriate donning. Additionally, new polymers are continually being developed with improved strength and barrier properties. Look for the newest improvements in vinyl polymer formulations that have made the examination gloves stretchier and stronger than vinyl gloves of the past.

What are the different types of synthetic gloves available? How do they compare with the dexterity, tactile sensitivity, flexibility, barrier properties, fit, and durability for which NRL is known?

Synthetic alternatives to natural rubber latex (NRL) gloves have evolved significantly over the last decade. The tensile and tear strength of Nitrile polymers are lower than NRL. Although most formulations remain inferior to natural rubber with regard to comfort, a few have been formulated to mimic the stretchiness of NRL. Despite its typical stiffness, the use of nitrile gloves for exam and laboratory situations has grown dramatically because of the excellent chemical resistance and barrier protection properties.

The newest of the synthetic materials, the Polyisoprene polymer has the same chemistry as natural rubber latex. However, not all polyisoprenes are the same. The characteristics of gloves manufactured form polyisoprene are based on their formulation and the processing technology used. Cardinal Healths polyisoprene compound formulation was specifically engineered to emulate the desired features of natural rubber latex (e.g., strength and barrier, elasticity, softness and conformance to hand).

Cardinal Healths computer controlled, proprietary compounding process maximizes the gloves physical properties, providing consistent protection and performance. Chloroprene has less overall tensile strength than NRL, however it typically shows good chemical resistance. Chloroprene polymers generally display less tactile sensitivity than NRL, and while they can be formulated for reduced stiffness, this can compromise their strength and tear resistance.

How does hand health affect glove choice and use?

Type IV or delayed hypersensitivity reactions involve a cell-mediated sensitivity to chemicals used in the manufacture of gloves and other rubber products. It manifests on the skin as a contact dermatitis rash (poison ivy-like). Symptoms may include redness, inflammation, or blister formation on areas that come in contact with the material. Type IV reactions are the most common allergic reactions to rubber products. Treatment for Type IV reactivity includes avoiding allergen contact and seeking local comfort measures. Because the reaction is to chemicals used to manufacture specific latex products and not to natural rubber latex itself, susceptible individuals often do not react to other latex products. Some gloves are formulated with reduced concentrations of chemical accelerators or different accelerators that individuals with Type IV hypersensitivity may be able to wear.

Irritant contact dermatitis is ranked as one of the top concerns in healthcare, and diseases of the skin are the No. 1 cause of occupational illness across all professions. Contact dermatitis is defined as an inflammation of the skin evidenced by itching, redness, and various skin lesions, due to contact with an irritating substance. Frequent handwashing and gloving can have detrimental effects on skin, including dryness, cracking, and increased sensitivity to handwashing products. Clinicians frequent occupational exposure to various soaps, detergents, disinfectants, and caustic chemicals are known to cause changes to the skin, which can be aggravated further by seasonal low humidity. Cardinal Health provides medical gloves coated on the inside with ingredients clinically proven to protect hands from moisture loss, restore smooth texture, moisturize, and soothe dry, flaking, and irritated skin.

How often should gloves be changed?

Frequency of changing gloves is dependent upon task, procedure, amount of blood and body fluid contact, and contact with instrumentation and sharps. The longer the same pair of gloves is worn, the greater the risk of barrier compromise, due to polymer film fatigue. Depending on these conditions, exam gloves may need to be changed every 15 to 30 minutes and surgical gloves may need to be changed at least every one to three hours.

What are the proper storage conditions for medical gloves?

All gloves should always be stored in original packaging and in environments that will not promote degradation by atmospheric conditions. Gloves have a shelf life of up to five years if stored properly.