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)

UNSTERILE GLOVES WITHOUT HANDRUB

COLLECTION OF THE SAMPLE

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.

USED GLOVES WITH HANDRUB

RUBBING THE USED GLOVES

DRYING THE GLOVES

COLLECTION OF THE SAMPLE

DATA ANALYSIS

Culture reports were analyzed using

Pearson Chi-Square test

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