Archive April 2017 XVIII, No. 4

Hole in One?

How we convinced our surgeons and staff to double-glove.

Kimberly Elgin, MSN, RN, CNOR, CLNC

glove puncture INDICATOR GLOVE Most glove punctures are tiny and identified only after surgery, not at the time of the incident. Wearing a darker-colored indicator glove makes it easier to spot breaches.

The first time you ask them to wear 2 pairs of gloves, they might look at you like you have 3 heads. But if you want to make double-gloving mandatory for all surgical staff directly involved or assisting at the operating field, you must have zero tolerance for the well-worn excuses you'll hear: too tight, too thick, too bulky, too cumbersome, loss of sensation, cuts off my circulation.

Not long after we made double-gloving mandatory, I spotted a surgical tech who wasn't wearing 2 pairs of gloves. When I asked him why, he said he was worried that he'd stick himself while passing suture or picking up instruments because of the "bulky and tight" double gloves. This is the kind of pushback you can expect, even though wearing double gloves has been proven to significantly decrease sharps exposures, as in the study that found that the underglove reduced exposure to patient blood by as much as 87% when the outer glove is punctured.

Hearts and minds
Yes, gloves are a very sensitive subject for your surgeons and staff. And rightfully so. Those who make their living in the OR are very touchy about their sense of touch. Some will be adamant that they can't function wearing 2 pairs of gloves. No way, no how, they'll insist. But once you break down the barriers with education and a double-glove trial, you'll quickly convert the naysayers. Remember, not all clinicians were trained to double-glove, so adopting the practice may require a change in behavior for some healthcare workers. But you might find that they'll feel no difference after double-gloving for as little as 2 weeks. It'll be their new normal, a learned behavior, just like wearing your seatbelt.

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