REUSE OF SAME GLOVES AFTER STERILE AND UNSTERILE PROCEDURES BY REPEATED USE OF HANDRUBS ANITA GEORGE DEPT. OF NEUROSURGERY JPN APEX TRAUMA CENTRE, AIIMS
Jul 12, 2015
REUSE OF SAME GLOVES AFTER STERILE AND UNSTERILE
PROCEDURES BY REPEATED USE OF HANDRUBS
ANITA GEORGE
DEPT. OF NEUROSURGERY
JPN APEX TRAUMA CENTRE, AIIMS
INTRODUCTION
HANDRUB
•Alcohol based liquid hand disinfectant
•Kills a broad range of nosocomial pathogens
•Active against bacteria, fungi & enveloped virus
•Possess an excellent immediate effect
•Excellent skin tolerability with long term use
BACKGROUND OF THE STUDY
Nurses have to frequently change the gloves for
various procedures like suctioning and positioning
in the same patients as well as between different
patients(around 10-15 times).So there is a
tendency to use the same gloves and there is a
high chance of breach in sterility
BACKGROUND OF THE STUDY
NAME AND YEAR
STUDY RESULT
Kampf G,Kramer A 2004
Epidemologic Background of hand hygiene & evaluation of the most important agents for rubs and scrubs
The best antimicrobial activity can be achieved with ethanol(60-85%), isopropanol(60-80%) & n-propanol(60-80%) and the activity is broad and immediate.
Clinical microbial rev,2004 oct:17(4):863-93
BACKGROUND OF THE STUDY cont.
NAME AND YEAR
STUDY RESULT
Karabay O et.al. 2005
Compliance and efficacy of handrubbing during in-hospital practice.
METHOD
Hand cultures were taken before and after procedure.
N=35Handrubbing with alcohol based solutions significantly reduced the bacterial contaminationof the nurses more than handwashing (54 and 27%respectively). Compliance was also better in the handrubbing group than the handwashing group(72.5% and 15.4% respectively;p value=0.001)
Med Princ Pract,2005 sep-oct:14(5):313-7
OBJECTIVE OF THE STUDY
To assess whether used gloves can remain sterile
by repeated washing with handrubs .
METHODOLOGY
Prospective study carried out in Neurosurgery I.C.U
over two month period(July-August 2011)
N=120
EXPERIMENTAL GROUP-UNSTERILE
GLOVES WITH HANDRUB(60)
CONTROL GROUP-UNSTERILE GLOVES(60)
STUDY METHOD (CONTROL GROUP)
Using convenient sampling, cultures of
unsterile gloves were taken by washing
gloves with sterile water after performing a
nursing procedure(to obtain culture fluid)
STUDY METHOD (EXPERIMENTAL GROUP) Similarly,cultures of glovewashed gloves were
taken after glovewashing with handrub and
subsequently washing gloves with sterile water
to obtain culture fluid(experimental group)
The culture of the glove wash was taken in
MacConkey blood agar media, kept at 37° C
for 24 hours.
RESULTS
N=120 Culture negative Culture positive
CONTROL GROUP(unsterile gloves)
36(60%) 24(40%)
EXPERIMENTAL GROUP(unsterile gloves with handrub)
58(96.7%) 2(3.3%)
P VALUE< 0.001
CONCLUSION
.Glovewashing is highly effective in
maintaining sterility of gloves
Therefore the study shows that it may be
practical to use used gloves by glovewashing
handrub.
This eventually can reduce the excessive use
of sterile gloves which is cost effective
IMPACT OF THE STUDY AND COST ANALYSIS
The use of a single pair of gloves in each shift has been practiced in TC 3 ICU since September 21st 2011
TOTAL COST FOR GLOVES IN A MONTH
PREVIOUSLY
6gloves * 3shifts * 20 patients * 30 days * Rs.11.98 = Rs.129384 PRESENTLY
I glove * 3shifts * 20patients * 30 days *Rs.11.98 =Rs.21564
DECREASE IN COST BY 83% WITHOUT INCREASE INFECTION RATES