Double Gloving Research Articles

Clean hands are caring hands: Improving anesthesia provider hand hygiene and double-glove compliance during induction of general anesthesia

Hand hygiene and double gloving practices during induction of general anesthesia can decrease transmission of bacteria to patients and subsequent healthcare associated infections; however, compliance to these practices is low. A pre/post-implementation quality improvement design was used with Plan-Do-Study-Act cycles. Several implementation strategies were used to improve hand hygiene and double glove compliance among anesthesia providers, including printed educational materials, video, in-person, and virtual meetings, visual reminders, audit and feedback, and improved access to hand sanitizer dispensers in the anesthesia workstation. Average hand hygiene compliance increased from 0% to 11.8% and double gloving compliance increased from 18.5% to 34.5%. A decrease in surgical site infections was shown in the post-implementation period. Although hand hygiene and double gloving practices increased after the initial implementation, the improvements were not sustained long-term. Practices to support sustainability, such as routine booster sessions, may be considered. Incorporating these quality improvement measures into practice may improve anesthesia provider hand hygiene compliance during induction of general anesthesia and impact subsequent infection rates.

Factors associated with correction of personal protective equipment nonadherence in a multidisciplinary emergency department setting: A retrospective video review

Despite local and national recommendations, health care provider adherence to personal protective equipment (PPE) varied during the COVID-19 pandemic. Previous studies have identified factors influencing initial PPE adherence but did not address factors influencing behaviors leading to correction after initial nonadherence. We conducted a retrospective video review of 18 pediatric resuscitations involving aerosol-generating procedures from March 2020 to December 2022 to identify factors associated with nonadherence correction. We quantified adherent and nonadherent providers, instances of PPE nonadherence, and time to correction. We also analyzed correction behaviors, including provider actions and correction locations. Among 434 providers, 362 (83%) were nonadherent with at least 1 PPE. Only 186 of 1,832 instances of nonadherence were corrected, primarily upon room entry and during patient care. Correction time varied by PPE type and nonadherence level (incomplete vs absent). Most corrections were self-initiated, with few reminders from other providers. Potential barriers to correction include a lack of social pressure and external reminders. Solutions include optimizing PPE availability, providing real-time feedback, and educating on double gloving. Most providers were nonadherent to PPE requirements during high-risk infection transmission events. The low correction rate suggests challenges in promoting collective responsibility and maintaining protective behaviors during medical emergencies.

Evaluation of sterile glove usage on digital tactile sensitivity using the Grating Orientation Task.

Surgical glove use may be associated with a decrease in tactile sensitivity, with thicker gloves or double-gloving techniques further altering sensation. This study evaluates digital tactile sensitivity by use of a Grating Orientation Task (GOT) with multiple sterile gloving techniques (no gloves, single standard gloving, double standard gloving, orthopedic gloves, and micro-thickness gloves). Each participant performed the GOT at increasing grating widths until correctly noting orientation in ≥8 of 10 trials with multiple glove types or double-gloving technique. Glove order was randomly assigned and participants were blinded to the orientation and dome size. All gloves except micro-thickness gloves showed increased threshold sensitivity values (i.e. worse fingertip sensitivity) when compared to control (micro:control, p = 0.105, others:control, p < 0.05). Single-layer gloves showed no significant difference in sensitivity when compared to orthopedic (p = 0.06) or double-layer latex gloves (p = 0.26). Standard latex gloves decreased fingertip sensitivity when evaluated with the GOT. Double-layer and orthopedic latex gloves do not decrease sensitivity when compared with single-layer gloving. Micro-thickness gloves may provide similar tactile sensitivity to no surgical glove.

Human papillomavirus and occupational exposure: The need for vaccine provision for healthcare providers

ABSTRACT To probe the understanding of healthcare providers regarding occupational exposure to human papillomavirus and their knowledge about human papillomavirus vaccination in relation to the American Society for Colposcopy and Cervical Pathology (ASCCP) recommendations. In this cross-sectional study, the healthcare providers at Mayo Clinic Arizona, Florida, and Minnesota were delivered an electronic survey. The survey was completed by 349 healthcare providers, with one respondent excluded for inconsistent entry. The mean age of respondents was 42.7 ± 10.9, and of those, 68% were female and 32% were male. Of the unvaccinated respondents, 43.3% were ≤ 45 y of age (eligible for vaccination), while those vaccinated formed 41% of the respondents. Healthcare providers are highly concerned about their cancer safety, as shown by their awareness of occupational human papillomavirus hazards and broad knowledge about vaccine efficacy. The use of personal protective equipment varied widely, including eyewear, double gloving, procedural face mask, N95 face mask, and/or nothing. Human papillomavirus and cancer risk was clearly perceived by healthcare providers. For professions, pairwise comparisons revealed that nurse practitioners, physician assistants, certified registered nurse anesthetists, and allied healthcare providers had lower scores than medical doctors. Despite the high level of understanding among healthcare providers of occupational human papillomavirus exposure, only a few of them knew of the recommendations of the ASCPP for vaccination of healthcare providers treating human papillomavirus-related diseases. In such cases, most of those surveyed embraced vaccination, which was considered 100% safe by medical doctors and allied health professionals.

EFFECTIVENESS OF DOUBLE-GLOVING METHOD ON PREVENTION OF SURGICAL GLOVE PERFORATIONS AND BLOOD CONTAMINATION: A PROSPECTIVE STUDY

Objectives: To evaluate efficacy of double gloving to provide mechanical barrier against communicable diseases and also to evaluate different parameters affecting glove perforation rate. Methods: This prospective study was performed in department of General Surgery at tertiary care teaching hospital of Gujarat. This study involved a group of surgeons and operation theatre nursing staff. Randomization of the participants was done with the closed envelope method in two groups: single gloving and double gloving. Glove perforation rate and hand contamination rate was calculated and compared between both the groups. Participants of double gloving groups were also asked for discomfort using double gloves and compromised tactile sensations. Results: There was no statistically significant difference in the glove perforation rate between single gloves and double outer gloves. (p=0.55) But, the glove perforation rate was significantly low in double inner gloves than single gloves. (p=0.004) The hand contamination rate was significantly lower amongst perforated double gloves than perforated single gloves. (p=0.00001) Awareness of glove perforation was absent in majority of the participants in both the groups. All the participants in the double gloving group were comfortable with using double gloves and their tactile sensations were not compromised. Conclusion: This study concluded that double gloving efficiently prevented hand contaminations during a surgery. There was no significant difference noted in glove perforation rates in both single and double gloving groups. Double gloving is recommended for the surgeons and nursing staff to protect them from blood borne infections and eliminate the chances of surgical site infections in the patients.

Disposable Nitrile Glove Resistance to Limonene: Dextrous Robot Hand Versus ASTM F739 Comparison.

The current technique to assess glove resistance to chemicals for worker protection relies on challenging a flat, 2.54 cm diameter glove piece at or near room temperature. This does not simulate a donned whole glove near the skin temperature subjected to work activity forces. Four different types of disposable nonpowdered unlined/unsupported nitrile gloves in triplicate were measured for thickness, porosity, and for the acrylonitrile content (A) of the challenge and collection sides. Limonene permeation at 35 °C through a whole glove on a clenching and nonclenching dextrous robot hand and with the standard ASTM F739 technique were facilitated by taking samples from the collection sides for GC-MS analysis. The standardized breakthrough time (SBT) when permeation reached 100 ng/cm2/min and the steady state permeation rate (SSPR) depended on A, thickness, and porosity. Only the thinnest glove (Lavender) showed statistically significant (p ≤ 0.05) increased average SSPR for the clenching hand relative to the nonclenching hand and for the ASTM technique. The ASTM test data for the three thickest gloves were not statistically different from those of the robot hand, but differed from the manufacturer's. More research with different chemicals and higher clenching forces is needed. Clenching forces can enhance the permeation. Workers wearing ultrathin disposable nitrile gloves have a higher potential for chemical penetration/permeation. Company glove permeation data obtained near room temperature may have a longer SBT and lower SSPR than in practice. Double gloving may be advisible in emergencies and for unknown chemicals when no appropriate thicker Chemical Protective glove is available.

How and why do healthcare workers use gloves in two Norwegian nursing homes?

Incorrect glove use can cause cross-contamination and healthcare-associated infections. Prior research has identified reasons for this, such as lack of indication, improper changing, and poor hand hygiene post-use. Limited research has investigated the reasons behind healthcare-workers' glove usage. To develop an in-depth understanding of healthcare-worker (HCW) attitudes and perceptions of glove use and explore barriers and facilitators as well as compliance with national guidelines. A small-scale convergent-parallel mixed methods study design consisting of observations with focus group interviews (FGIs) by using the Systems Engineering Initiative for Patient Safety model (SEIPS). The study was conducted at two Norwegian municipal nursing homes in Oslo for two weeks in January-February 2023. Out of 73 observations, gloves were used in 67 episodes, not worn even if indicated in six observations, and were overused sixteen times (21.9%). Lack of hand hygiene after glove removal was observed in 36 out of 67 instances (53.7%). Two FGIs disclosed that glove usage decisions are shaped by habits, knowledge, experience, and emotions linked to patient requirements, tasks, and glove type. Double gloves were used for self-protection and efficiency. Availability of gloves was a facilitator, while poor glove quality posed a barrier. Despite HCWs' knowledge of glove guidelines, their attitudes did not consistently always ensure compliance. This study underscores the need for targeted interventions to improve hand hygiene after glove removal, urging awareness of glove overuse to reduce infections, protect HCWs' skin, and promote sustainability. N/A.

The effect of exposure to cold on dexterity and temperature of the skin and hands

Objectives. This study aimed to determine the impact of low temperature (−1 °C, +5 °C) on manual dexterity and hand skin temperature after 1 h of exposure when using two types of protective gloves. Methods. Ten male participants wore double gloves or single gloves, when spending 1 h in a climatic chamber at −1, +5 or +20 °C. Before and after the cold exposure, measurements of mean weighted body skin temperature, hand skin temperature, the Purdue Pegboard Test and hand grip strength were performed. Results. There were statistically significant differences in the values of mean weighted body skin temperature and left and right hand skin temperature between the study variants. Conclusion. No effect of cold exposure (−1 °C, +5 °C) on manual dexterity was observed, but there was an effect of −1 °C temperature change on weighted mean skin temperature and hand skin temperature during 1 h of exposure. The decrease in both right and left hand skin temperature after cold exposure was the largest for −1 °C while using single gloves, and differed significantly from the other variants.

SAT559 Challenges Involved in Managing a Paraplegic Patient with Metastatic Papillary Thyroid Cancer Requiring Radioactive Iodine Therapy

Abstract Disclosure: G. Al-Naqeeb: None. E. Munger: None. P. Veeraraghavan: None. C. Cochran: None. P. Bernaldez: None. P. Wong: None. N. Devaraj: None. T. Fisher: None. K. Lee: None. O. Owoade: None. I. Jones: None. S. Gubbi: None. J. Klubo-Gwiezdzinska: None. Background: High radioactive iodine (RAI) therapy doses utilized for treating thyroid cancer patients require a 24-48-hour radiation isolation period until the total effective dose equivalent exposure (TEDE) to the general population does not exceed 5mSv. We present a unique scenario of a paraplegic patient with metastatic papillary thyroid cancer (PTC) requiring RAI therapy and the radiation precaution strategies implemented by our team to reduce radiation exposure risk to the medical staff.A 69-year-old female with RAI-refractory tall cell-variant PTC (pT4aN1bM1; BRAF V600E pathogenic variant) with pulmonary metastases, paraplegia due to a motor vehicle accident with neurogenic bowel and bladder, was referred to our center for management of PTC. Laboratory data revealed a serum thyroglobulin of 2313 ng/mL (normal=1.6-59.9), and anatomical imaging showed numerous pulmonary nodules that had increased in size and number compared to prior imaging from 6 months ago. Due to disease progression, re-differentiation therapy with dabrafenib was initiated. After 3-months of dabrafenib therapy, a diagnostic thyroid hormone withdrawal-aided 131I scan with dosimetry revealed a significant re-induction of RAI uptake in pulmonary lesions and it was determined that therapy with an RAI dose of 200 mCi would not exceed a safe radiation exposure to the bone marrow of 200 rads. A multi-step mitigation strategy was developed based on a multidisciplinary team meeting and appropriate mock sessions. Stay times were estimated for individuals based on historical TEDE following the care of non-paralyzed patients receiving similarly prescribed activity. To minimize exposure to nursing staff, the patient’s Foley catheter was shielded with lead lining and bowels were emptied the night before RAI with a laxative. For each entry, posted safety sheets were updated with one-foot and one-meter isodose lines and on-contact exposure rates. Two nurses and one radiation safety staff member donned full personal protective equipment (PPE; full body suit, double gloves, booties, face covering) in the staging area and entered via lane one. While nursing provided direct care needs, radiation safety staff emptied the shielded catheter, organized clutter and packaged radioactive waste containers. Upon completion of duties, staff exited via lane two, removed PPE, and performed a full personnel contamination survey in the staging area. The patient successfully underwent RAI therapy with 200 mCi. Six months later the serum thyroglobulin had reduced to 48.4ng/ml with a substantial reduction in pulmonary metastatic tumor burden on imaging studies. Conclusion: Post-RAI therapy care of paralyzed patients during radiation isolation poses a unique challenge to medical staff warranting modifications in routine care practices, which can be achieved safely through optimal planning and enhanced training. Presentation Date: Saturday, June 17, 2023

Poster 7 - Examining the impact of a double glove technique on infection rates of peritoneal dialysis catheter insertion sites

Poster 7 - Examining the impact of a double glove technique on infection rates of peritoneal dialysis catheter insertion sites

Prevention of contamination after endotracheal intubation using a dedicated sleeve.

Contamination of work surfaces by used laryngoscopes after endotracheal intubation is a serious infection control concern but no strategies are available to address it. We assessed if contamination of the surfaces after endotracheal intubation would be reduced when providers used a dedicated, self-erected, disposable plastic sleeve (BladePouch) to store the used laryngoscope as compared to using single gloves or double gloves and sheathing the laryngoscope with the outer gloves. Twenty participants were recruited including attending physicians, trainees and allied health care professionals. They performed endotracheal intubation on a mannequin with oral cavity coated with a dye and stored the used laryngoscope blade using single gloves, double gloves or BladePouch. Each participant used both direct and video laryngoscopes. Following intubation, dye contamination of gloves, gown and work surface was evaluated. There was no difference in the contamination of gloves or gowns between the single gloves, double gloves or BladePouch groups. However, work surface contamination was significantly reduced when using BladePouch compared to single or double gloves (13% vs. 100% vs. 80% respectively, P<0.001). The odds of work surface contamination were significantly lower with BladePouch vs. single or double gloves, even when adjusted for intubation device, role and experience of participants with an adjusted odds ratio of 0.0054 (95% confidence interval: 0.0009-0.0314), P<0.001. In conjunction with standard precautions, the use of a dedicated plastic sleeve to store contaminated laryngoscope blade after endotracheal intubation may reduce the work surface contamination, independent of intubation device, role and experience of providers.

Characterization of education, technical practices and attitudes of Portuguese pharmacy technicians towards manipulation of cytotoxic drugs.

Pharmacy professionals that manipulate cytotoxic drugs need to undergo educational programs, adopt the most convenient practices, and use appropriate equipment to avoid, as far as possible, occupational exposure to cytotoxic drugs. The main goal of this work is to characterize the education, technical practices, and attitudes towards cytotoxic drugs, of Portuguese pharmacy technicians. A questionnaire comprising eleven questions deemed pertinent was elaborated and subsequently validated by a pilot test. The anonymous, web-based survey was conducted between December 2022 and January 2023, by graduated pharmacy technicians that had manipulated cytotoxic drugs between 2017 and 2022. A total of 77 pharmacy technicians responded to the survey. Although sixty-six pharmacy technicians (86%) had been trained before beginning to manipulate cytotoxic drugs, the promotion of regular post-admission training by the institutions is sparse - only assumed by 53% of the pharmacy technicians (n = 41). All participants reported using gloves and gown during manipulation and the use of double gloves was common (99%; n = 76). Compliances with the recommended limit time for uninterrupted manipulation activity (82%; n = 63) and systematic double-checking (86%; n = 66) were high, but the regular use of sterile gauze around syringe connection sites 58% (n = 45), was less frequent. None of the surveyed pharmacy technicians used closed-system transfer devices (CSTD) and 41 (53%) of those who used spikes did not thoughtfully use these devices. The implementation of regular training programs in manipulating cytotoxic drugs should be fostered, to promote the more judicious use of engineering controls and transversal adoption of the safest technical practices.

Gloves Contamination During Revision Surgery for Periprosthetic Joint Infection

BackgroundThe use of double gloving has become a standard practice for joint replacement surgeons. However, since there are limited data on how gloves are contaminated during both primary and revision arthroplasty, no precise protocol exists to direct surgeons on when, or if, to change their gloves. The goals of this preliminary study were to evaluate the contamination of gloves during total joint arthroplasties (TJAs). MethodsWe included 25 infected cases and 10 primaries, which were performed at the same institution using the same surgical protocol from 3 fellowship trained surgeons. Samples were taken every 20 minutes from the start of the surgery until the joint was irrigated. Procedural steps were noted. To evaluate cross-contamination during infected cases, we sampled gloves using blood agar plates. In primary cases, culture swabs of anterior chamfer cuts and sterile instruments on the back table were used as negative controls. Next-generation sequencing (NGS) was used as an adjunct to identify low virulence bacteria. ResultsIn the primary cases, all samples were found culture negative but 3 (8.1%) of the 37 samples were found to have a low, unidentifiable bacterial mass via NGS testing. In the infected cases, 41 (59.4%) of the 69 samples yielded positive microbial results. The positivity rate was higher in the samples collected after the arthrotomy was performed (70%) compared to samples collected before the arthrotomy was performed (40%), and the surgeon was only dissecting superficial layers (P = .502). ConclusionGloves seem to be a common source of cross-contamination in the intraoperative field during revision TJA. Due to the higher percent of positive samples following the opening of the joint, we hypothesize that the arthrotomy allows for the spread of bacteria across the operative site. While further investigation is necessary to formulate a precise protocol for the changing of gloves during TJA, it may be beneficial to perform a thorough irrigation of the joint and change of the gloves immediately following arthrotomy.

Skin problems associated with the use of personal protective equipment by healthcare workers during COVID-19 pandemic in Türkiye.

Skin problems associated with the use of personal protective equipment (PPE) have been reported during the COVID-19 pandemic. To determine the skin problems experienced by healthcare workers in Türkiye who used PPE during COVID-19 and the effect of these problems on their quality-of-life. This cross-sectional study was conducted from 30 November 2020 to 30 May 2021. Data were collected from 404 healthcare workers recruited via social media. Participants completed a skin problem evaluation form and Skindex-16, which measures the effects of skin disease on quality-of-life. The t test and ANOVA were used to analyse differences between the means. Most (85.1%) of the participants were nurses and 38.6% worked in COVID-19 intensive care units. All the participants wore gloves (53.2% wore double gloves), 99.3% wore surgical masks and 56.2% wore protective glasses. They washed their hands on average 31.94 [standard deviation (SD) 27.55] times a day. Skin problems developed were mostly around the forehead, hands, nose, and ears. The mean (SD) Skindex-16 score was 45.42 (26.31). Based on Skindex scores, respondents with chronic skin problems had a significantly lower quality-of-life than those without skin problems, as did those who developed skin problems during the COVID-19 pandemic than those who did not (P < 0.001). Skin problems associated with the use of PPE increased during the COVID-19 pandemic and these affected the quality-of-life of healthcare workers. Further studies should evaluate how to minimize adverse reactions due to PPE use.

Risk of microbial transmission by reusing gloves after alcohol-based hand hygiene

Disinfection of gloves might reduce the workload of healthcare workers, protect the environment, and bring economic benefits. Thus, the safety of hand hygiene of gloved hands is an important issue. We aimed to evaluate the risk of microbial transmission by comparing residual micro-organisms after multiple patient contacts, with or without gloves, in clinical practice. Researchers, two with gloved hands (single or double gloves) and one with bare hands, made rounds of patients, followed by alcohol-based hand rub. Hand imprints were obtained before and after the rounds and cultured. The number of colony-forming units (cfu) of gloved and bare hands was compared, and the colony distribution was evaluated semi-quantitatively by hand region. A total of 108 imprints were obtained after 10 rounds. The median cfu counts were significantly higher in the gloved hands (single and double) than in the bare hands (9.00 vs 3.50, P=0.028). The cfu counts of single- and double-gloved hands were higher after than before contact (P=0.044 and P=0.001, respectively). Carbapenem-resistant Acinetobacter baumannii was identified in a pair of double gloves after a round, which included patients with the same organism with identical antibiotic susceptibility results. The mean percentage of colony-growing compartments from gloved hands was significantly higher than that of bare hands in the finger and wrist regions (P=0.019 and P=0.049, respectively). Compared with bare hands, reuse of gloves increased residual microbial colonies and potential for transmission of multi-drug-resistant organisms, even after using alcohol-based hand rub.

Evaluation of fluid leakage at the coverall and glove interface in single and double glove conditions

BackgroundFluid leakage through the glove-protective clothing interface is an area of concern for many health care personnel, including emergency medical service providers, who may wear coveralls to protect themselves from multiple types of hazards. There is currently no established standard test method to specifically evaluate the barrier performance of the glove-protective clothing interface region for any personal protective equipment ensemble. ObjectiveThis study quantifies the fluid leakage at the coverall and glove interface using single and double gloving. MethodsA robotic arm, which can simulate upper extremity movements of health care personnel, was used to test 5 coverall models and an extended examination glove model in single and double glove conditions. ResultsThe results show that there was a significant difference in fluid leakage amounts between some of the coverall models and the number of glove layers studied. Findings also highlight that there is a high correlation between basis weight and stiffness of the coverall fabrics and the fluid leakage amounts. ConclusionsThese results underline that coverall constructed from thin and less stiff fabrics can result in lower fluid leakage levels. Also, there was no significant difference in fluid leakage amounts between single and double gloves when tested with each of the coverall models, with the exception of the coveralls with the highest basis weight and stiffness.

Rubber gloves in orthopaedic surgery (part II): Cooke and Goodyear; Halsted and Caroline's gloves of love; from cotton to rubber after Perthes' experiments; double glove technique with Urist.

This study determines the timeline for surgeons adopting rubber gloves and the double glove technique in the operating room for orthopaedic surgery. Using the vague historical terms of discovery, acceptance, commonplace, and consistency, we analyzed the influence of the different actors in each period. Cotton or silk was used for early gloves; they were permeable, sometimes coated with paraffin. Uses of rubber date to the 1600s when the Mesoamericans used rubber to make shoes. After the discovery of rubber in 1735 by the French scientist Charles de la Condamine in Peru, the rubber glove was imagined in 1834 and done for the first time by R. F. Cooke. The acceptance of rubber gloves arrived when the Goodyear-Rubber Society began to manufacture rubber gloves. Halsted, at Johns Hopkins Hospital, negotiated in 1889 with the Goodyear Rubber Company to produce thin rubber gloves to protect his nurse's hands from the dermatologic effects of the carbolic acid used to sterilize instruments. Commonplace to protect patients from bacteria of hand surgeons necessitated several decades. Dr. Joseph Bloodgood (Halsted's senior resident) remarked that gloving the surgeon with rubber gloves reduced the infection rate. Still, surgeons were reluctant to wear gloves that impaired the sense of touch. Laboratory experiments performed by G. Perthes on cotton and rubber gloves were necessary to generalize rubber gloves for practice in orthopaedic surgery. Consistency of the double-glove technique arrived during World War II when M. Urist proposed the double protection against bites from bone or bullet fragments while exploring war wounds. Only in 1965, when The Ansell Rubber Company utilized gamma irradiation as a low-cost method of sterilizing the gloves they produced, did disposable gloves become sterile. This article helps to understand the detailed discussions before surgical gloves' modern operating equipment.

Surgical experience and different glove wearing conditions affect tactile sensibility

BackgroundThe fingers’ tactile sensibility is essential in surgery, especially in microsurgery. Therefore, surgeons seeking to improve their performance often prefer certain glove brands and wearing habits. There is the need of objectively testing these glove wearing conditions and determine the effect of surgical experience with regard to tactile sensibility by comparing surgeons with non-surgeons. MethodsThis cross-sectional single-center pilot-study was conducted between June and August 2021. Two groups of 27 surgeons and 27 non-surgeons underwent two-point-discrimination (2PD) and Semmes-Weinstein monofilament testing (SWMT) of both index fingers with bare hands and with wearing six different brands of surgical gloves. Different wearing conditions, such as single-gloving, double-gloving, well-fitted, under- and oversized gloves, were evaluated within and between the groups. ResultsMost glove types decreased tactile sensibility (2PD and SWMT) of surgeons and non-surgeons. Interestingly, the thinnest gloves showed similar 2PD values to bare hands in both groups. Double-gloving negatively impacted SWMT, without influencing 2PD. Undersized gloves showed better 2PD and SWMT than well-fitted gloves, while oversized gloves showed no tactile drawbacks. With bare hands and certain glove conditions, the surgeons' 2PD and SWMT was significantly better than the non-surgeons’, indicating a positive effect of surgical experience on tactile sensibility. ConclusionOur study demonstrated the positive impact of surgical experience on tactile sensibility, as demonstrated by the surgeons. The sensibility of the gloved hand varies on the surgical glove type, but favors thinner gloves, single gloving (rather than double gloving) and undersized or well-fitted gloves.

Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery.

The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice. The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates. At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations. Risk of sharps injury was relatively high due to the high incidence of glove perforation.

HIV-related stigma among healthcare providers working within infectious diseases and gynecology and obstetrics at a large teaching hospital in Denmark

ABSTRACT HIV-related stigma experienced in healthcare settings may be particularly detrimental to people with HIV (PWH). This study aims to examine the drivers of stigma and enacted HIV-related stigma among healthcare providers working in HIV and non-HIV care at a large teaching hospital in Denmark. In total, 162 providers working in gynecology and obstetrics, and 57 providers working in infectious diseases completed the “Measuring HIV stigma and discrimination among health facility staff” questionnaire. Compared to providers working in infectious diseases, providers working in gynecology and obstetrics had less training in infection control, HIV, and stigma, and although their level of worry and negative attitudes toward PWH was overall low, they were more like to use extra precaution measures (e.g., double gloves) when caring for PWH (20% versus 0%). Addressing HIV-related stigma in healthcare is important, as any amount of HIV-related stigma from providers has the potential to compromise the patients’ engagement in care and health outcomes.