Nursing wound care survey: Sterile and nonsterile glove choice

Abstract

Purpose: The application of sterile and clean procedure to the practice of wound care nursing was examined. Design: This prospective, descriptive study surveyed staff nurses regarding glove use. Subjects and Setting: Seven hundred forty-three staff nurses from five health care agencies in the San Francisco Bay Area responded to the survey. Instruments: A self-report wound care survey instrument was developed by Nursing Consortium for Research and Practice members from information adapted from the wound care literature. The questionnaire comprised 31 questions and required approximately 10 minutes to complete. Methods: Nursing Consortium for Research and Practice members obtained approval from their respective institutional human subjects committees and distributed questionnaires among all nurses engaged in direct care. Some agency representatives personally handed the survey instruments to subjects, but most distributed them through their agencies' personnel mailing systems. Results: Seven hundred twenty-three (38%) of 1900 questionnaires were completed and returned to the five site coordinators. Differences were found between acute care and home health nurses. Acute care nurses were more likely than home care nurses to use sterile gloves in all wound care situations. Conclusion: Greater variation was found with regard to sterile technique in wound care practice than in previously reported studies. Although patient risk factors and wound type significantly influenced the choice of sterile or clean gloves, additional environmental and personal factors exerted considerable influence. These included health care setting, degree of professional education, and nurses' experiential background. Attempts to modify practice through policy change alone may not be sufficient to overcome resistance to change. Instead, it may be necessary for nurses to “unlearn” lessons from basic nursing education before they can adapt to new practices and clinical policies.