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Focus on What’s Necessary at Year’s End
The holiday season can throw some employees off track, draining their levels of engagement and enthusiasm for their jobs at the end of a long year....
You've come to the right place if your surgeons and OR staff aren't happy with the gloves they're using, or if you're just looking for a better glove or a better deal. Not only will we break down a product category that continues to evolve and innovate, but we'll also highlight some of the many interesting surgical glove options out there so you can know if a glove is worth trialing.
Easy-to-don powdered gloves were banned by the FDA in 2017, and latex gloves, which many surgeons prefer, are being phased out by many facilities because of the risk of allergic reactions to surgeons, staff and patients. That's led to a range of powder-free, non-latex, synthetic options. Pardon the pun, but there's no one-size-fits-all gloves solution.
There are numerous factors you should consider when thinking of buying surgical gloves.
- Know your materials. If it weren't for the allergy risks, time-tested latex gloves would likely still be the gold standard for many surgeons. They gained a deserved reputation over decades for their durability, comfort, safety and feel, and many surgeons who never experienced an allergic reaction associated with their use have been reluctant to give them up. As with many things in health care, some clinicians understandably feel that if something isn't broken, it doesn't need fixing. And for quite a while, synthetic alternatives to natural latex simply weren't up to their standards.
With an increasing number of facilities moving away from latex, the goal of synthetic gloves is to replicate the satisfyingly tactile feel and dexterity that latex provided with materials that don't present allergy risks to surgeons, staff or patients.
Early synthetic glove materials like nitrile and neoprene were "very strong and chemically resistant, but had poor elasticity, so it took a lot more force to stretch them compared to latex. This is a big issue because surgeons, especially those doing more delicate procedures, were struggling with the gloves. And if you double-glove with a glove that's inelastic, it can be really, really tough to avoid hand fatigue and cramping," says Chris Lavanchy, engineering director of the Health Devices Group for ECRI Institute in Plymouth Meeting, Pa., an independent nonprofit organization that advises providers on the safety and cost-effectiveness of medical practices and products.
Another problem surgeons have experienced with synthetic gloves, says Mr. Lavanchy, is a stickiness that makes them difficult to don. The industry has responded by using techniques like chlorination, which makes the inner surface of the glove more slippery and easier to slide over the fingers.
Over the years, there's been a move away from nitrile gloves toward other synthetic materials. "We do still see some nitrile gloves," he says. "But we're seeing quite a few hospitals adopting polyisoprene or polychloroprene gloves. Their properties have been adjusted to make them more similar to latex."
Ironically, reports of skin problems have emerged with synthetic gloves, as the move away from latex was based on similar concerns. These aren't usually allergies, though; Mr. Lavanchy says they have to do with chemical accelerators used in the manufacturing of synthetic materials, or additives meant to make the gloves easier to don. Exacerbating the problem is all of the scrubbing that surgeons and OR staff must do. "That constant scrubbing is very hard on the hands," he says. "They're exposed to a lot of stressors." Like latex allergies, these sensitivities won't be immediately apparent after one use, but rather develop over time.
Bottom line, every material has its advantages and disadvantages, as well as relative variability in cost; some synthetics have prices that might give cost-conscious facilities pause. There's no silver bullet here. You'll need to put in the time and effort to evaluate the worthiness of the available options for your specific situation. And that leads us to our next point.
- Communicate — and listen. It's vital to educate everyone who works in your ORs, as well as administrators, risk management and purchasers, about exactly why you're looking to make a change. Is it performance? Is it cost? Another reason? At the same time, get feedback from all of your stakeholders. What problems have they had with the gloves they're using? What do they and don't they like about them? What features or characteristics of gloves do they need, or are most important to them? Strength? Durability? Flexibility? Feel? Elasticity? Not falling down in the middle of a procedure?
This will narrow down the number of products suitable for evaluation. Keep in mind that different types of surgical procedures might require gloves with different features and characteristics. You'll see specifications like tensile strength, elongation, puncture resistance and freedom from holes that can help guide you in different directions depending on your needs. In facilities that double-glove as recommended by many industry organizations, you might evaluate both undergloves and overgloves, which should be different colors so holes and perforations are more easily identifiable. With Ansell's Glove-in-Glove System, outer (semi-transparent) and inner (green) gloves are pre-donned and aligned at the finger tips for easy double-gloving in a single don.
- Hold glove trials. "The trialing of gloves is something we strongly encourage when we're talking to [facilities] that are looking for replacements for what they're currently using," says Mr. Lavanchy. "But it's evident that it's not always a painless process." That's because surgeons and staff might have disagreements over which gloves on trial are the best.
Explain the advantages and disadvantages of each glove on trial. Provide as much education and information as possible; bring vendor reps in to help with the process. Then let everyone try them on and give them a spin. Get your OR team's feedback — the most valuable data points you can use to inform your decision.
"Sometimes you learn a lot just in a short trialing of a glove," says Mr. Lavanchy. "You might find they don't offer the sizes you were looking for, or the way that the glove fits isn't right, or a surgeon's hands get really fatigued when using the glove. All of these things can be very subtle."
Beyond its clinical worthiness, evaluate the glove's cost-benefit. Use any leverage you might have with a supplier to negotiate lower prices. And remember that fewer SSIs will result in better patient outcomes and satisfaction, which could improve reimbursements and attract more patients. Shelf life is important, too. OSM
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