Does Glove Color Matter?

Not so long ago, the presence of color in a disposable glove indicated a latex-free glove. Nitrile exam gloves were usually some shade of blue. Latex gloves were a natural color, and looked like – well, latex.

But not anymore.

Nitrile exam gloves are now available in a rainbow of colors. Nitrile cleanroom gloves come in colors other than the standard white. And latex gloves are available in colors other than “natural.”

While choice is nice, does glove color matter?


Cleanroom Glove Color

In cleanroom and controlled environments, contamination is a constant concern. Contaminants can come from the glove, other materials, and from the workers.

White cleanroom gloves are the industry standard. Contamination is easier to see on a white glove. White also conveys and promotes the “clean” message to workers.

Color is a glove additive, and additives can react with the product or process. For this reason, less color is preferred. This is also true for white cleanroom gloves, as white is also an added color. Some white gloves contain less dye than others, reducing the risk of unwanted reactions.

While white is the industry standard, there are use cases for a colored cleanroom glove. A blue cleanroom glove may provide more contrast, making it easier for workers to do their job well.

Glove Color in the Lab

Laboratories are frequently faced with the possibility of cross-contamination. This can happen when an employee inadvertently transfers substances from one area of the lab to another on their gloved hands.

Assigning a specific glove color to each area of the lab can help. For instance, blue gloves could be used in one area, and white nitrile gloves in another. Wearing different colored gloves provides supervisors and employees a visual cue. This can help prevent costly errors caused by cross-contamination.

Colored Medical Gloves

Health care facilities often prefer a colored nitrile. This helps staff differentiate between latex and non-latex gloves.

A shade of blue is the traditional nitrile color of choice in medical facilities. But in recent years other colors such as gray, purple, and pink have become common.

Glove color can be useful in identifying glove failure. Double gloving, wearing a dark glove underneath a light colored glove, can help reveal punctures and small tears.

A Rainbow of Dental Gloves

Glove manufacturers that focus on the dental industry have marketed a rainbow of colored and scented nitrile and latex gloves.

Some dental offices like to color-coordinate their scrubs and gloves. Other offices prefer to use a dark blue nitrile exam glove to reduce the visibility of blood. For the dental hygienist, glove selection is most often a matter of personal choice.

Because glove color has become an effective marketing and branding tool, we will likely continue to see new exam glove colors. Glove color choice will still be influenced by the industry, purchasing decisions and cost.

What do you think?  Does glove color matter?

Editor’s Note:  This post was originally published on Dec. 13, 2011 and has been completely revamped and updated for accuracy and relevancy.

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Do Your Medical Gloves Pass the Viral Penetration Test?

Do Your Medical Gloves Pass the Viral Penetration Test?

There are millions of types of viruses in the world. Viruses that infect human cells cause diseases ranging from the common cold and chicken pox to hepatitis C, SARS, Ebola and Zika. Healthcare workers, emergency responders and researchers are exposed to these sometimes deadly viruses.  How can they be sure that their personal protective equipment (PPE,) including their medical gloves, will help keep them safe?

No manufacturer can guarantee that their product will eliminate the risk of virus transmission. There are, however, standard tests that help ensure the wearer a high level of protection from viruses.

ASTM F1671

One of these standards is ASTM F1671, Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Blood-Borne Pathogens Using Phi-X174 Bacteriophage Penetration as a Test System.

This test, usually referred to as the Viral Penetration Test, is a pass or fail test designed to show whether the material can protect a wearer from viruses that can be transmitted via blood and body fluids.

Test Procedure

ASTM F1671 Test ChamberTo conduct the test, swatches of the test material are conditioned for 24 hours at a certain temperature and humidity. The samples are then loaded into penetration test cells. Each test cell reservoir is filled with about 60 ml of Phi-X174 Bacteriophage suspension – a surrogate for viruses like HCV, HBV and HIV.

After allowing the fluid to sit for five minutes, air pressure is applied at 2 pounds per square inch gauge (psig) for one minute. After the minute is up, the pressure is released and the sample is allowed to sit for nearly an hour.

Throughout the test, the samples are monitored for fluid penetration. The specimens are then tested with a biologically based assay. Based on test results, the samples pass or fail ASTM F1671.

Virus Protection and Your Gloves

While the FDA does not require this test for medical gloves, the National Fire Protection Association does. NFPA Standard Number 1999 was developed to ensure that protective garments, gloves and facewear that are worn during a medical emergency operation will give a high level of protection from bloodborne pathogens like viruses.

Medical gloves that pass the Viral Penetration Test are considered to be highly protective against bloodborne virus transmission. Both RoyalTouch300 and FreeStyle1100 Nitrile Exam Gloves pass this test. Double gloving can provide added protection.


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Advances in Hand Hygiene Compliance

Advances In Hand Hygiene Compliance

Hand hygiene is the most effective means of reducing hospital-associated infections (HAIs.) Infection prevention is critical to saving lives and reducing cost of care. Yet maintaining a high level of hand hygiene compliance continues to be a real challenge. Hospital visitors may not be aware of the need to use handwashing stations available in hallways, and healthcare workers (HCWs) often miss opportunities for proper hand hygiene due to a variety of reasons.

Determined to improve quality of care, hospitals are employing new and novel means to help HCWs comply with hand hygiene requirements and maintain high levels of compliance.

Targeted Solutions Tool®

In 2006 Memorial Herman Hospital System (MMHS,) consisting of 12 hospitals and over 200 alternate-site facilities and programs, set the goal of becoming a high reliability organization (HRO.) HROs maintain high levels of quality and safety over long periods with few adverse events.

Working toward this goal, Robust Process Improvement® projects proved effective in reducing HAIs, but more could be done by addressing hand hygiene compliance. MMHS implemented the Joint Commission Center for Transforming Healthcare’s Web-based Targeted Solutions Tool® (TST®.)

The TST enabled MMHS to measure compliance rates using secret observers, identify reasons for noncompliance and implement tested interventions provided by the TST. Most importantly, they were able to sustain those improvements.

MMHS found that the number one contributing cause of hand hygiene noncompliance at their hospitals was improper use of gloves, which includes not washing before or after wearing gloves. Other frequent contributing causes included frequent entry and exit of patient areas, hands being full of supplies, being distracted or forgetting, following a person during entry or exit, and ineffective or inconvenient placement of hand gel dispensers or sinks.

Interventions to increase compliance included using a code word to remind a distracted person to perform hand hygiene, relocating or adding hand gel dispensers, and providing a surface for HCWs to place supplies and medications so they could perform hand hygiene.

MHHS’s system-wide hand hygiene compliance averaged 84.4% during the “improve” phase compared to the baseline average of 58.1%. They ultimately achieved 95.6% compliance in the final 12 months of the study. All that effort paid off with fewer HAIs. Adult ICU central line-associated bloodstream infections decreased by 49%, and ventilator-associated pneumonia decreased by 45%.

To sustain these gains, MMHS continues to collect and input data on hand hygiene compliance, and each hospital’s hand hygiene team is responsible for sustaining performance.

Remote Video Auditing (RVA) with Feedback

For a more high-tech approach, a technology that has been shown to dramatically improve hand hygiene compliance in the food processing industry is now doing the same in hospitals – RVA with feedback.  The system captures and audits images and provides real-time feedback to practice areas. While it sounds ominous – cameras watching your every move – it encourages compliance in a positive way with a non-punitive approach.

NS-LIJ’s North Shore University Hospital in Manhasset, NY employed the RVA system from Arrowsight to improve hand hygiene compliance in their medical intensive care unit (MICU.) The baseline snapshot of compliance before feedback was low, around 10 percent.

Over a 16-week period, HCWs were monitored and received real-time feedback in aggregate on LED screens mounted on the walls of the MICU and from team leaders. Each shift was able to clearly see their compliance rate which naturally motivated improvement. Within weeks the hand hygiene compliance rate soared to 80 percent, then reached a sustained rate of 90 percent during the 17 month maintenance period.

Some feel this method is superior to “secret-shoppers” or observation by individuals with clipboards in hand. When we know we are being watched, we act differently.

His Eyes Are On You

Even when we aren’t being watched, just the image of a man’s intense staring eyes above a handwashing station can prompt compliance.

Employing behavioral science, researchers at a teaching hospital in Miami found that a picture of a man’s eyes increased hand hygiene by one-third at an intensive care unit. Interestingly, a picture of a woman’s eyes saw a lower compliance rate than no picture at all. This may be because of gender differences in exerting social influence, or it may have just been because the man’s eyes showed more facial musculature, which is perceived as anger or a threat. In any case, this low-tech “cue” works.

Figure 2. 

Pure Hold Hygiene Handles

PureHoldDoor knobs and handles are notorious for harboring germs, making them common sources of infection transmission. Frequent wipe-downs with a germicide are not enough to halt viruses looking for their next ride.

Enter the Pure Hold Hygiene Handle. It sprays a hand sanitizing gel on the person’s hand as they open the door. Lab testing and trials have proven that these sanitizer dispensing door handles are 98.5 percent cleaner than a standard door handle.

The hands that open them are also cleaner. At Queen Alexandra Hospital in Portsmouth, hands that used the system were 87.5 percent cleaner than those that did not. The special handles are also used in the cleanroom, pharmaceutical and food processing industries to reduce possible contamination of critical environments. Employing the door handle as the method of dispensing handwashing gel ensures that more people comply with efforts to stop viruses and HAIs.

Hand hygiene compliance, including the proper use of medical gloves, is a critical factor in reducing HAIs. Increasing and maintaining that compliance among healthcare workers is made possible by employing new and novel methods and technology.

Endotoxin Testing of Surgical and Cleanroom Gloves

Endotoxin Testing of Surgical and Cleanroom Gloves

Endotoxins are large molecules found in the outer membrane of Gram-negative bacteria. If enough of the molecules get into the bloodstream of humans or animals, they produce a variety of inflammatory responses. Symptoms range from fever and septic shock to low blood pressure and respiratory distress.

Gram-negative bacteria are ubiquitous – found in soil, water and living organisms – so avoiding them isn’t an option. Glove testing and manufacturing controls are employed to reduce the risk of transmission during surgery, whether from surgical gloves or other medical devices.

Endotoxin Testing

To lower the risk of infection and possible death, sterile medical gloves and some cleanroom gloves are tested for endotoxin contamination.

Horseshoe-CrabUSP Chapter <85> Bacterial Endotoxins Test. There are 3 methodologies to detect or quantify endotoxins in sterile medical and cleanroom gloves – Gel Clot, Turbidimetric and Chromogenic. All three methods utilize a reagent produced from the lysate of amoebocytes (white blood cells) of the horseshoe crab (Limulus polyphemus or Tachypleus tridentatus.) This test is often referred to as Limulus Amoebocyte Lysate or LAL.

The average contaminant concentration is reported in endotoxin units per device (glove pair.) The FDA has set a limit of 20 EU/device for medical devices that have direct or indirect contact with blood or lymph fluid. Devices that come into contact with cerebrospinal fluid have a much lower limit – 2.15 EU/device.

Contamination Control

To reduce the amount of contamination on their end product, medical device manufacturers need gloves with low endotoxin levels for their employees. Endotoxin contamination on gloves can vary.

In a 2007 study performed by the Malaysian Rubber Board, endotoxin contamination on latex surgical and examination gloves varied widely between brands. The non-sterile examination gloves tested ranged from <8.4 EU/glove pair to as high as 9,632 EU/glove pair. Most of the sterile surgical gloves in the study were generally clean, with most in the minor to moderate contamination range. A few, however, did test much higher than the FDA limit.

These potentially deadly, fragmented remains of bacteria are bioactive and difficult to kill. Endotoxins can adhere to medical implants and devices, even after sterilization.

Thus, endotoxin contamination control is an important part of medical device manufacturing. Glove manufacturers use a variety of technologies and environmental controls to reduce particulate and biological contamination. The most common approach is to package surgical and cleanroom gloves in a cleanroom environment or white room that is regularly cleaned and sanitized, and operated by workers that are gowned and gloved.

Although bacterial endotoxins are everywhere in our environment, thorough testing and diligent contamination control can result in safe medical devices that enhance our lives.


Glove Testing Demystified – Tensile Strength and Ultimate Elongation

Glove Testing Demystified - Tensile Strength and Ultimate Elongation

Glove material strength and stretch are important factors in a glove’s quality and performance. Medical and cleanroom gloves undergo testing according to ASTM D412 to meet International standards. This ensures you get a glove that is not prone to tear or fail, and has adequate stretch.

What is ASTM D412?

ASTM D412 is one of over 12,000 standards that operate globally under ASTM International. The current version of the standard is D412-06a(2013) Tensile Properties of Vulcanized Rubber and Thermoplastic Elastomers – Tension.

In this standard, glove material is measured for tensile stress (or tension,) tensile strength, yield point and ultimate elongation.

The Tests

InstromIn Test Method A, a die cut “dumbbell” shaped piece of glove material is stretched from either end by a machine at a constant speed until it breaks. The computer on the machine collects the data as the piece is stretched. Once the piece breaks, the sample’s elongation is measured and recorded.

The test is repeated on samples that have been put through the accelerated aging process in heating chambers according to ASTM D573. This test simulates the glove’s physical properties at the end of its shelf life. This is a “worst case” scenario. Many gloves that have been stored properly, in a cool, dry place away from sunlight, heat and humidity, will have better strength and elongation than the “after aging” test results.

Tensile strength is measured in MPa, or megapascals. The minimum tensile strength for latex exam gloves before aging is 18 MPa, and 14 MPa after aging. The minimum tensile strength for nitrile exam gloves is 14 MPa both before and after aging.

The minimum elongation for latex gloves before aging is 650%, and 500% after aging. Nitrile gloves have a minimum elongation of 500% before aging, and 400% after aging.

Typical Performance vs. ASTM Minimums

Most gloves, however, are manufactured with much higher tensile strength and elongation properties than the ASTM minimums. The typical performance of HandPRO® RoyalTouch300™ Nitrile Exam Gloves during its shelf life, for example, is a tensile strength of 28-32 MPa and an ultimate elongation of 520 – 560%.

HandPRO® Cleanroom gloves are also manufactured to exceed ASTM minimums. HandPRO® Series 9100 Clean Class 100 Nitrile Gloves have a typical tensile strength of 27.1 – 31.0 MPa after aging, and a 540-560% ultimate elongation after aging.

Tensile Strength and Elongation in Use

So what do these numbers mean for you when selecting and wearing gloves?

While high tensile strength is preferred, the “highest” number does not necessarily mean “best” performance. Glove manufacturers must carefully balance strength with stretch and comfort. Too high tensile strength will make a glove stiff or difficult to don.

Elongation is important to the performance of the glove. High elongation helps the glove material stretch instead of tear when snagged. A glove with good elongation will stretch and conform to your hand, improving comfort and performance.

RoyalTouch300 Delivers Optimal Performance and Protection

RoyalTouch300 Nitrile Exam Gloves

We are excited to announce the newest member of the HandPRO® family of nitrile exam gloves – RoyalTouch300™. This powder-free glove features a revolutionary design, providing the optimal performance and protection you desire.

Strength + SensitivityRoyalTouch300 Nitrile Exam Gloves

If you wear gloves, perhaps in a dental or medical office, laboratory or manufacturing environment, you know there is a balance to be struck between tactile sensitivity and durability.

If a nitrile glove material is too thin or brittle, there will be frequent tears, especially at the cuff when donning.  If the glove is too thick, you get durability but sacrifice needed sensitivity.

The RoyalTouch300™ nitrile material hits that “sweet spot” between glove thickness and strength. While being incredibly sensitive, the tensile strength typical performance surpasses the leading comparable glove – 31 MPa compared to 23 MPa. This means fewer tears, less waste and reliable protection.

Request your free sample pack.

Chemical Protection

RoyalTouch300™ is certified with PPE Category III (EN 374:2003 Part 3,) providing unsurpassed film strength and chemical resistance properties among comparable products.

In testing, the glove achieved the highest Performance Level 6 for common chemicals such as 50% sulphuric acid, 40% sodium hydroxide, 50% gluteraldehyde and 10-13% sodium hypochlorite.

Comfort Contour + Finger-Texture

Comfort and functionality are also important. To ensure RoyalTouch300™ lives up to its name, the glove features proper contour design and surface treatment so they go on easy and feel fabulous. Textured fingers provide a secure grip in a wide-variety of environments.

Environmentally-Friendly, Cost-Saving Packaging

Optimal performance doesn’t stop at the glove. Packed flat in a 300-count box that fits in a standard-size glove box holder, the gloves dispense easily to reduce unintended glove waste.

The more efficient packaging minimizes product and shipping costs – an important consideration to everyone ordering gloves today.

Compared to standard 100-count packaging, the environmentally-friendly RoyalTouch300™ packaging design reduces waste by 42% and optimizes storage space by 56%. This means fewer reorders, more space on your shelf for other supplies, and less packaging waste in our landfills.

RoyalTouch300™ delivers a unique and cost-effective combination of strength, protection, comfort, sensitivity, feel and functionality so that you can work with confidence. Truly the Royal Treatment!

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Powder-Free Exam Glove Choices – Chlorinated vs. Polymer-Coated

Chlorinated vs. Polymer Coated Gloves

When disposable exam gloves first came into high demand, most gloves were powdered. Without the powder, gloves were difficult to don and doff. But cornstarch powder became a problem. Today, powder-free exam gloves are the healthcare industry standard.

So how do glove manufacturers make a glove donnable without cornstarch powder?

Glove factories employ one of two treatments – chlorination or polymer coating.

Chlorinated Disposable Gloves

In the online chlorination process, exam gloves on formers are dipped in a dilute chlorine solution. This reduces surface friction and tack on the interior of the glove. The glove is then washed in an aqueous ammonia solution, then washed in water and dried. The result is a strong glove that dons easily, with a surface pH close to that of water.

Double-chlorinated gloves receive this treatment on both the inside and the outside of the glove. These gloves are smooth with low tack and suitable for double-donning.

Chlorination is desirable in disposable latex gloves. The process significantly reduces the level of extractable latex proteins, making the glove less likely to cause latex allergy in the wearer. Nitrile exam gloves are chlorinated when no polymer coating is preferred.

Polymer-Coated Disposable Gloves

In this newer process, a polymer coating is applied to the interior surface of the glove, giving it a smooth finish for fast and easy donning. The coatings normally used on medical gloves include hydrogels, acrylics, silicone polymer, polyurethane, polymer-blends and nitrile.

Polymer coatings are odor-neutral and promote consistent, even color. Most white nitrile exam gloves are polymer coated, as chlorination causes yellowing.

In latex gloves, polymer coatings provide a barrier between the latex glove material and the wearer, helping to limit the migration of latex protein.

Both chlorination and polymer coatings are effective at creating a glove that dons and doffs easily. Done correctly, both processes yield gloves that exceed FDA and ASTM standards for hand protection.

Surveillance, Robots and Gloves Fight Spread of CRE


The superbug CRE, or carbapenem-resistant Enterobacteriaceae, has roared back into national headlines. This multi-drug resistant hospital-acquired infection (HAI) is much feared for good reason. The death rate is as high as 50%.

The current news reports are focused on hard to clean duodenoscopes. These scopes are used in more than half a million medical procedures each year, and are responsible for at least eight CRE outbreaks nationwide.

Health care professionals are taking new measures to fight the spread of CRE.

Testing Scopes for CRE

Hospital infection control directors at many hospitals are heeding the alarm and stepping up surveillance. Swedish Medical Center now performs daily cultures of these scopes to check for hard to kill Gram-negative germs like CRE. After being cleaned and tested, the instruments are held until they are proven free of dangerous bacteria. This test-and-hold policy is a pending protocol being developed by the Centers for Disease Control and Prevention (CDC.) No doubt it will go far in fighting the spread of CRE.

National Surveillance

Currently, only 20 states require health care facilities to report CRE. While this is a dramatic increase from just two years ago when only 6 states required reporting, many officials now feel that there should be national surveillance of CRE with all states required to report.

“CRE infections already are endemic in several major U.S. population centers, including New York, Los Angeles and Chicago, which account for hundreds of confirmed cases. Smaller pockets of cases have been reported across much of the country, including Oregon, Wisconsin, Minnesota, Pennsylvania, Maryland, Virginia and South Carolina.” – USA TODAY

Other experts advocate taking surveillance beyond mandatory reporting. To assist hospitals with infection control isolation, Illinois runs a state registry of CRE-infected patients.   Health officials can survey hospital lab data for CRE, and hospitals can routinely monitor high-risk areas.

When Los Angeles last conducted a county CRE survey in 2011, they discovered a lot more cases than they expected.   The study revealed 675 cases for a one-year period ending in May 2011.

“Two-thirds of the 102 acute-care hospitals analyzed had at least one case. The infection rate was significantly higher inside the eight long-term-care facilities reviewed.” – Los Angeles Times

Surveillance and reporting will help experts understand how CRE is transmitted in the health care system so they can better fight its spread.

UV Robots

Some health care organizations are employing the use of new technology to kill CRE and other deadly germs in hospital rooms – robots that emit ultraviolet light.

Merlin, a 5-foot tall robot made by San Antonio-based company Xenex, cost Providence Tarzana Medical Center just over $100,000. In just five minutes, Merlin sends out 450 pulses of UV light, obliterating drug-resistant bacteria like CRE from door handles to bed rails.

Nearly 300 of these robots are working hard to fight the spread of CRE in health care facilities here in the US.

Hand Hygiene and Glove Use

While germ-zapping robots may be coolest new tool to fight CRE, the front lines are still proper hand hygiene and glove use.

The CDC recommends 8 core measures to prevent the spread of CRE.

Number one on the list is strict adherence to hand hygiene.

  • “Hand hygiene is a primary part of preventing multidrug-resistant organism (MDRO) transmission.”
  • “It is not enough to have policies that require hand hygiene; hand hygiene adherence should be monitored and adherence rates should be fed directly back to front line staff.”
  • “Further information on hand hygiene is available at CDCs Hand Hygiene in Healthcare Settings

Number two is the Proper Use of Contact Precautions, including:

  • “Performing hand hygiene before donning a gown and gloves”
  • “Donning gown and gloves before entering the affected patient’s room”
  • “Removing the gown and gloves and performing hand hygiene prior to exiting the affected patient’s room”

Patients requiring ventilators, on urinary and intravenous catheters, and patients on long courses of certain antibiotics are at higher risk for CRE infections. With new surveillance, new technology, and diligent adherence to proper hand hygiene and glove use, we can minimize the risk to millions.

What is your health care facility doing to fight the spread of CRE?  Share your comments below.


Medical Gloves Essential to Mitigate Ebola, SARS Outbreaks

Every day a diverse group of health care workers rely on medical gloves to guard against contracting or transmitting dangerous contagions.

In countries where gloves, face masks and other personal protective equipment (PPE) are readily available, it can be easy to take this first line of defense for granted.

Unfortunately, in many places around the world, medical gloves are frequently unavailable. This results in the sudden and sometimes explosive spread of infectious disease.

Ebola Spreads for Want of Gloves

Nowhere is this lack of basic protection more pronounced at the moment than in the West African countries of Guinea, Liberia, and Sierra Leone.

In Liberia, medical gloves are so scarce that doctors wrap their hands in plastic grocery bags to deliver babies, and nurses must routinely care for the ill with bare hands. Gloves are reserved for only the sickest of patients, and are often reused.

In Sierra Leone, where Ebola has been reported in every district, 30% of hospitals lack sterile gloves and 70% lack protective eyewear.

With conditions so ripe for the transmission of disease, the Ebola outbreak spread quickly from its epicenter in southeastern Guinea. As of September 18th there have been 5,347 suspected and confirmed cases, with 2,630 suspected case deaths, making it the largest Ebola outbreak to date and the first epidemic of the virus.

These numbers include an unprecedented number of health care workers. Because they lack gloves and other PPE, or do not use them properly, the World Health Organization (WHO) reported on August 25th that more than 240 doctors and nurses have contracted Ebola. Over 120 have died.

Understandably, health care workers are demanding gloves and other PPE before returning to work.

In the meantime, outside organizations such as WHO and Centers for Disease Control and Prevention (CDC) have stepped in to provide support and coordinate workers, supplies and training. Clinics are being reopened, but these are quickly inundated with newly sick patients.

The greatest need continues to be the availability and proper use of basic PPE – gloves, face masks and protective eyewear. Without this first line of defense, it will be difficult to mitigate the Ebola outbreak.

SARS Lessons

The 2003 SARS epidemic taught us some valuable lessons. Foremost is the importance of controlling the disease at its source. That means strict adherence to infection control practices, including proper hand hygiene and gloving.

Unfortunately, due to familiarity or lack of time, heath care workers sometimes took shortcuts. The result? Hospital workers treating SARS patients became infected.

To halt the spread, hospitals placed monitors outside patients’ rooms to ensure everyone strictly followed infection control procedures. Only then was the deadly spread of SARS stopped.

Medical gloves, so ubiquitous with health care in the U.S. and much of the world, are a crucial piece of health care equipment often missing in other countries. The availability and proper use of gloves and other PPE is critical to halting the spread of infectious diseases such as Ebola and SARS.

Even in countries where gloves are in every patient contact area, vigilance and diligence in adhering to infection control practices is critical to everyone’s safety.


Hand Hygiene Before Gloving – How Important?

Hand Hygiene Before Gloving - How Important?

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?

Recent studies on unused, non-sterile exam gloves removed from glove boxes in patient areas suggest it really is that important.

Glove Contamination in the ICU

At University Medical Center, a 412-bed tertiary care hospital in Lubbock, TX, a study compared rates and burden of non-sterile glove contamination among specialty ICUs.

A total of ninety glove pair samples were taken from occupied rooms in a 32-bed Medical ICU, a 21-bed Trauma/Surgical ICU, and a 6-bed Burn ICU.  The gloves were collected from glove boxes housed in glove box dispensers or patient carts in patient rooms where health care providers had unrestricted access to the gloves.

The results?

“We found an average contamination rate of 81.1% across all glove pairs sampled with an average bioburden of 5.83 CFU (SD = 8.04).”  These findings were consistent with previous studies, where contamination rates were 55-87% and average bioburdens ranged from 3.4-6.2 CFU per glove pair.

The study also found evidence of methicillin-resistant organism (MRO) contamination on 36.7% of glove pairs sampled.  The study noted that “because our contamination rate estimate most likely underestimates the true rate of MRO contamination due to the selective culturing process followed, actual rates of MRO contamination may be higher than those reported in this study.”

Pathogen Contamination in a Large Ward

Another study conducted in New Zealand investigated glove use on a hospital orthopaedic ward to examine whether pathogen contamination occurs prior to contact with patients.

Glove samples were removed from boxes on opening and days 3, 6 and 9 thereafter.

The results?

“Total bacterial counts ranged from 0 to 9.6 x 103 cfu/glove.  Environmental bacteria, particularly Bacillus species, were present on 31/38 (81.6%) of samples.  Half (19/38) the samples were contaminated with skin commensals; coagulase negative staphylococci were predominant.  Enterococcus faecalis , Klebsiella pneumoniae , Pseudomonas sp. or methicillin susceptible Staphylococcus aureus were recovered from 5/38 (13.2%) of samples.  Significantly more skin commensals and pathogens were recovered from samples from days 3, 6, 9 than box-opening samples.”

Clearly, both studies demonstrate that health care workers can introduce pathogenic bacteria into glove boxes, and unused, non-sterile exam gloves can become pathogen transmission vehicles in hospitals and potentially other healthcare settings.

Adhering to handwashing guidelines and performing hand hygiene before donning gloves is a critical, not to be skipped step in reducing the spread of dangerous bacteria.


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