Making informed decisions on appropriate glove choices is always about matching the level of risk involved in the task to be completed to suitable products.
Nurses, caregivers, and other healthcare workers typically use examination gloves. The risk of the job should be considered when deciding between latex, vinyl and nitrile exam gloves. Gloves ARE required for procedures where there is a risk of cross-infection between patients and staff and further risk assessment should be carried out.
Latex and nitrile gloves are commonly used when dealing with high-risk situations involving blood, bodily fluids or patients with infectious diseases. Both latex and vinyl gloves can be used for low-risk, general procedures such as a non-invasive physical exam. However due to the prevalence of latex allergies, many health care establishments have now become ‘latex free’, deciding on non-latex high protection alternatives such as nitrile and synthetic gloves.
Surgical gloves are higher quality and designed specifically for the accuracy and sensitivity required by surgeons.
What Are Acceptable Quality Levels (AQL) And Why Are They Important?
It is one of the responsibilities of European standards makers to decide what percentage of defects is permissible in any market. European Standards state that medical examination gloves shall have an acceptable quality level or AQL of 1.5 because they felt that the internationally accepted AQL of 2.5 did not provide sufficient protection for European Healthcare Workers and so set a stricter level of 1.5.
This means that it is acceptable for up to 1.5% of all gloves that are made to contain a hole. Therefore, a lower AQL number means that there is less risk of encountering a defect, and therefore a lower risk of transmitting infection. However, it means that higher levels of inspection are required, leading to increased prices.
When To Wear Sterile Vs. Non-Sterile Gloves
Sterile gloves are used primarily for surgical purposes and must meet stringent standards based on an acceptable quality level of pinholes. Sterile gloves have a lower acceptable quality level (AQL 1.0) compared to non-sterile gloves (AQL1.5) Due to the stricter standards and testing required, sterile gloves are more expensive than non-sterile gloves. Studies show that in non-surgical procedures, there is no link between using non-sterile gloves and increased rates of infection. Therefore, most healthcare workers opt for non-sterile gloves for non-surgical procedures.
When To Wear Sterile Gloves
Procedures which require a sterile field and high-barrier protection, e.g:
- Lumbar punctures
- Liver biopsies
- Clinical care to surgical wounds / drain sites
- Procedures for neutropenic patients
- Insertion of urinary catheters
- Vaginal examination in obstetrics
Sterile Nitrile Examination Gloves are designed for medical procedures, offering a high quality and dependable sterile latex free glove, they are compliant with Class1 Sterile Medical Devices Directive 93/42/EEC (2007/47/EC) and its series of European Standards EN455 parts 1, 2, 3 and 4. They are manufactured in accordance with European PPE Directive 89/686/EEC, standards EN420 and EN374.
When To Wear Non-Sterile ‘High Protection’ Gloves
- If there is a risk of contact with blood,
- Procedures involving high-risk of exposure to Blood Borne Viruses and where high barrier protection is needed, e.g:
- Potential exposure to blood / body fluids e.g. blood spillages, faecal incontinence, blood glucose monitoring, administering enemas / suppositories and rectal examinations
- Handling cytotoxic material
- Handling disinfectants
- Venepuncture / cannulisation
- Vaginal examination
- Basic care and specimen collection procedures on patients known or suspected to be high risk of Blood Borne Viruses
- Non-surgical dentistry / podiatry
- Handling dirty/used instruments
- Processing specimens in high protection non sterile gloves i.e. nitrile or synthetic needs to be provided.
Non-Sterile Gloves Which Provide High Levels Of Protection
Nitrile examination gloves provide a high level of protection, are a superior fit with higher durability, a good barrier and are latex free. They have a higher unit cost than other gloves, due to their superior quality, which means they are less cost effective to use for low risk procedures.
Synthetic examination gloves also offer a high level of protection. They are softer and more flexible than standard vinyl and a more comfortable fit. They are a lower cost option than nitrile and can also be used where there is a risk of contact with blood.
When To Wear ‘Low Level Protection Gloves’
If the gloves are required for a low risk procedure not involving blood including tasks where there is a low-risk of contamination, non-invasive clinical care, or environmental cleaning for example:
- Oral care
- Emptying catheter drainage bags
- Emptying urinals / bedpans and suction jars
- Handling low-risk specimens
- Clinical cleaning
- Dressing wounds when contact with blood / body fluids is unlikely e.g. gastrostomy dressings
- Endotracheal suction
- Applying creams
- Touching patients with unknown skin rash / scabies / shingles
- Making beds / changing clothing of patients in isolation then a suitable quality vinyl is acceptable.
Non-Sterile Gloves Which Provide Lower Levels Of Protection
Medical grade vinyl examination gloves with an AQL 1.5 offer a lower level of protection and also a good fit. However, those who choose vinyl as an acceptable alternative to nitrile are putting staff and patients at risk when dealing with blood, as vinyl tears more easily, and therefore increases the risk of cross contamination. Vinyl is suitable for low level risk procedures in nursing home environments.
Are Gloves Always Necessary?
Gloves are NOT required for procedures where there is minimal risk of cross-infection between patients and staff e.g.
- Basic care procedures without contact with blood or body fluids
- Transferring food from food trolleys to patient bedside
- Making uncontaminated beds/changing or removing patients’ uncontaminated clothing
- Taking recordings (BP, temperature, pulse)
- Closed entrotracheal suction
HCSUK work in partnership with the leading suppliers of medical examination gloves to ensure that you have the best range of high quality gloves available for your needs.
All of the gloves are continually tested to maintain quality and are manufactured to BS EN 455 to comply with all Health and Safety requirements.
This allows us to offer you both the best advice and gloves to suit your individual application so that you can provide your staff with the optimum protection against all types of infection.
Image source: Canva