Survey of AORN Congress Attendees Reveals Concern About Surgical Glove Punctures

WASHINGTON, D.C. Nurse attendees at this weeks Association of PeriOperative Registered Nurses (AORN) Congress in Washington, D.C., report they are very concerned about the risk of surgical glove punctures which could ultimately effect their career if exposure to infectious bloodborne pathogens result from the puncture.

In a random sample of 612 nurses at the AORN Congress, Regent Medical asked about glove perforation detection issues. When asked how concerned they are about the risk of surgical glove punctures which could ultimately effect their career if they were exposed to infectious bloodborne pathogens as a result of the puncture, 82 percent of survey respondents said they were very concerned, while 15 percent said they were somewhat concerned.

Only 1 percent of operating room nurses responding to the survey indicated that they estimate single glove perforations are recognized 100 percent of the time and 14 percent said they are recognized 75 percent of the time. Almost one-third responded that they are recognized 50 percent of the time.  According to the survey, 98 percent of respondents said this estimation is based on personal experience and intuition.

Survey respondents also were asked about double glove perforations. Five percent said that while double gloving increases safety, they estimate outer glove breaches are detected 75 percent of the time; 11 percent responded that they are detected 65 percent of the time. Another 15 percent thought they are detected 45 percent of the time. 

When asked how they detect glove breaches in the presence of fluid, 71 percent said they watch for them with the naked eye. Fifty-four percent said they would consider a double gloving system that alerts the wearer through a visible puncture indication system if a breach occurs to be superior protection, yet 68 percent said they dont currently use such a system.

Double gloving can significantly decrease risk.(1)  Professional societies also support double gloving as a means of reducing risk in certain procedures. The Association of periOperative Registered Nurses states, Wearing two pairs of gloves (i.e., double-gloving) may be indicated for some procedures to reduce the potential for contact with blood and body fluids.(2) The American College of Surgeons Committee on Operating Room Environment says, Double gloving does help to cut down by a factor of 10 the number of potential exposures(3)

A healthcare professionals risk of exposure and the subsequent potential for seroconversion can be  significant.  Published seroconversion rates are hepatitis B virus (HBV), 1/10; hepatitis C virus (HCV), 1/20; and HIV, 1/300.(4)

Double-gloving is an important risk management tool, says Carolyn Twomey, director of clinical affairs for Regent Medical. Industry surveys show glove failure rates vary from 11 percent to 51 percent,(5) so we believe it is critical to take measures to protect both the practitioner and the patient as much as possible. Our Biogel® Patented Puncture Indication System is the only proven system that clearly lets you know when the outer glove has been perforated in the presence of fluid, Twomey adds. Use of a patented double gloving system results in significantly greater detection of punctures (78 percent) during the operation than using single glove (42 percent)(6). In a recent study, researchers found double gloving with an indicator system provides the best protection and allows the timeliest identification of perforations.(7)

References:

1. Perry J, Jagger J. Lessons from an HCV-Infected Surgeon.  Bulletin of the American College of Surgeons 2002; 87:8-13.  Accessed at: http://www.facs.org/fellows)_info/bulletin/perry0302.pdf on September 24, 2002.

Standard and Transmission-Based Precautions.  AORN 2002 Standards, Recommended Practices and Guidelines; AORN:2002.

2.  AORN. 2002 Standards, Recommended Practices and Guidelines: 2002. AORN, Inc.

3. ACS. Preventing Disease in the Operating Room.  Panel discussion.  American College of Surgeons Spring Meeting.  April 29, 1998.  Accessed at http://www.facs.org:80/about_college/acscomm/core/coreprev.html.

4. OSHA seeks plan to curb needlesticks.  The American College of Orthopedic Surgeons Bulletin 1998; 1 (84).

5. Quebbeman EJ, et al. Double Gloving: Protecting Surgeons from blood contamination in the operative room Archives of Surgery 1992; 127:213-217.

6. Naver LPS, Gottrup F, Incidence of glove performance in gastrointestinal surgery and the prospective, randomized controlled study, Eur J Surg 2000: 166:293-295.

7. Florman S et al.  Efficacy of Double Gloving with an Intrinsic Indicator System.  Surgical Infections 2005; 6(4):385-395.

Source: Regent Medical Ltd.