Surgical Gloves in health care

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Surgical Gloves in health care


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WHAT IS A GLOVE • A glove Middle English from Old English glof is a garment covering the whole hand. Gloves have separate sheaths or openings for each finger and the thumb if there is an opening but no or a short covering sheath for each finger they are called fingerless gloves. 2/20/2016 Dr.T.V.Rao MD 2

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History of Gloves • Gloves appear to be of great antiquity. According to some translations of Homers The Odyssey Laërtes is described as wearing gloves while walking in his garden so as to avoid the brambles. Other translations however insist that Laertes pulled his long sleeves over his hands. Herodotus in The History of Herodotus 440 BC tells how Leotychides was incriminated by a glove gauntlet full of silver that he received as a bribe. There are occasional references to the use of gloves among the Romans as well. Pliny the Younger c. 100 his uncles shorthand writer wore gloves in winter so as not to impede the elder Plinys work. 2/20/2016 Dr.T.V.Rao MD 3

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Rubber Glove • A rubber glove is a glove made out of rubber. Rubber gloves can be unsupported rubber only or supported rubber coating of textile glove. Its primary purpose is protection of the hands while performing tasks involving chemicals. Rubber gloves can be worn during dishwashing to protect the hands from detergent and allow the use of hotter water. Sometimes caregivers will use rubber gloves during the diaper changing process to prevent contact with the childs fecal material/urine. Health professionals use medical gloves rather than rubber gloves when performing surgical operations. 2/20/2016 Dr.T.V.Rao MD 4

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Gloves Patient care environmental services other • Glove material – vinyl latex nitrile other • Sterile or non-sterile • One or two pair • Single use or reusable PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 5

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Medical gloves • Medical gloves are examples of personal protective equipment that are used to protect the wearer and/or the patient from the spread of infection or illness during medical procedures and examinations. Medical gloves are one part of an infection- control strategy. 2/20/2016 Dr.T.V.Rao MD 6

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Medical gloves • Medical gloves are disposable and include examination gloves surgical gloves and medical gloves for handling chemotherapy agents chemotherapy gloves. These gloves are regulated by the FDA as Class I reserved medical devices that require a 510k premarket notification. FDA reviews these devices to ensure that performance criteria such as leak resistance tear resistance and biocompatibility are met. 2/20/2016 Dr.T.V.Rao MD 7

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What gloves should be worn •The gloves worn should be able to provide protection from exposure to blood-borne viruses for the duration of the tasks being undertaken. 2/20/2016 Dr.T.V.Rao MD 8

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What gloves should be worn •This may mean having to change them safely mid- task if they become damaged and/or having to wear a combination of more than one type of glove to provide additional physical protection: 2/20/2016 Dr.T.V.Rao MD 9

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What you should know before using medical gloves •Wash your hands before putting on sterile gloves. ••Make sure your gloves fit properly for you to wear them comfortably during all patient care activities. 2/20/2016 Dr.T.V.Rao MD 10

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Caution using the Gloves • Be aware that sharp objects can puncture medical gloves. • •Always change your gloves if they rip or tear. • •After removing gloves wash your hands thoroughly with soap and water or alcohol-based hand rub. • •Never reuse medical gloves. • •Never wash or disinfect medical gloves. • •Never share medical gloves with other users. 2/20/2016 Dr.T.V.Rao MD 11

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Do’s and Don’ts of Glove Use • Work Opportunities from “clean to dirty” • for “touch contamination” - protect yourself others and the environment – Don’t touch your face or adjust PPE with contaminated gloves – Don’t touch environmental surfaces except as necessary during patient care PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 12

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How to Don Gloves • Don gloves last • Select correct type and size • Insert hands into gloves • Extend gloves over isolation gown cuffs PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 13

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How to Safely Use PPE • Keep gloved hands away from face • Avoid touching or adjusting other PPE • Remove gloves if they become torn perform hand hygiene before donning new gloves • Limit surfaces and items touched PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 14

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Sequence for Removing PPE • Gloves FIRST • Face shield or goggles • Gown • Mask or respirator PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 15

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Where to Remove Gloves • At doorway before leaving patient room or in anteroom • Remove respirator outside room after door has been closed Ensure that hand hygiene facilities are available at the point needed e.g. sink or alcohol-based hand rub PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 16

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How to Remove Gloves 1 • Grasp outside edge near wrist • Peel away from hand turning glove inside-out • Hold in opposite gloved hand PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 17

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How to Remove Gloves 2 • Slide ungloved finger under the wrist of the remaining glove • Peel off from inside creating a bag for both gloves • Discard PPE Use in Healthcare Settings 2/20/2016 Dr.T.V.Rao MD 18

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When to do Double gloving •For some surgical work eg orthopaedic or dentistry where additional physical protection may be needed double gloving the use of glove liners or of knitted or steel weave outer gloves may be appropriate and are proven to be beneficial. 2/20/2016 Dr.T.V.Rao MD 19

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Use of Gloves in Post-mortem examination • For some work such as post mortem examination or embalming where there is a risk of exposure to blood- borne viruses as well as the requirement to use knives saws etc pierce and cut- resistant gloves are likely to be needed in addition to those providing microbiological protection. 2/20/2016 Dr.T.V.Rao MD 20

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Allergies with Gloves •Latex allergies are becoming common with prolonged use of latex gloves and the use of nitrile or vinyl gloves is recommended to avoid becoming sensitised. It is recognised however that within certain work environments latex gloves are still used in large numbers due to their efficacy and relatively low cost. 2/20/2016 Dr.T.V.Rao MD 21

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Allergies with Gloves •If latex gloves are worn then powder free low protein content materials must be chosen to help prevent latex allergy. Powdered gloves should be avoided as they can increase skin irritation and the likelihood of allergy development. Where latex gloves are in use appropriate health surveillance should be implemented. 2/20/2016 Dr.T.V.Rao MD 22

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Hand hygiene and disposable gloves • It is important to remember that glove use is not a replacement for effective hand washing and the two should work together to protect the wearer and others such as a patient or client being treated. Key requirements are: • When using disposable type gloves your hands should be washed and dried thoroughly before putting the gloves on • Where client or patient treatments are involved a fresh pair of disposable examination-style gloves must be worn for each procedure and must be disposed of between procedures to avoid cross-infection. Never wash and reuse disposable gloves 2/20/2016 Dr.T.V.Rao MD 23

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Gloving is not Replacement for Hand Washing We should not forget Hand Washing is great step in prevention of spread of Infectious diseases • If you work anywhere in the health care industry you are likely aware of the importance of performing proper hand hygiene and glove use to reduce the spread of infectious organisms. • In the “Five Moments for Hand Hygiene” as outlined by the World Health Organization WHO the first “moment” for performing hand hygiene is Before Patient Contact. • But is this step really necessary especially when you are about to don a pair of gloves before touching the patient 2/20/2016 Dr.T.V.Rao MD 24

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Gloving is not Replacement for Hand Washing We should not forget Hand Washing is great step in prevention of spread of Infectious diseases 2/20/2016 Dr.T.V.Rao MD 25

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Hand Hygiene and Disposable gloves •If you need to stop work temporarily eg to answer a phone always remove and discard the gloves you are wearing and replace them when you continue working •Always wash your hands after glove removal - gloves are not a replacement for hand washing and •Moisturising hand cream applied after hand washing can help prevent skin drying after frequent washing. Such products should never be relied upon as a physical barrier to protect the skin from infection. 2/20/2016 Dr.T.V.Rao MD 26

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References •1The use of gloves Health and safety executive internet resource •2 Guidance for the Selection and Use of Personal Protective Equipment PPE in Healthcare Settings CDC resource •Medical Gloves FDA •Wikipedia on Gloves 2/20/2016 Dr.T.V.Rao MD 27

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Attention of viewers • I am thankful to many in the world who made me to achieve my desired goals faster than I thought having 3-5 million health professionals share and utilize my knowledge for the benefit of mankind Today I wish to be freelancer to the world to create interest in Medical Clinical and Diagnostic Microbiology with more emphasis on Infectious diseases and Hospital associated Infection wish to be your partner in educating many millions who know well the importance of Infectious diseases • You can visit many web sites of mine • • • • • Be a friend on Facebook with tummalapalli venkateswararao access • Rao’s Microbiology • Rao’s Infection care • Microbiology connected Travancore Medical College • For any assistance on INFECTION REAL TED ISSUES CONTACT ME AT •Mob +91 7204113154 2/20/2016 Dr.T.V.Rao MD 28

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•Program file crated by Dr.T.V.Rao MD for benefit of Medical and Paramedical Professionals in the Developing World for Scientific use of Surgical Gloves •Dr.T.V.Rao MD •Freelance Clinical Microbiologist 2/20/2016 Dr.T.V.Rao MD 29

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