Do surgeons use double gloves during surgery? Results of a survey.

<b>Introduction:</b> The perforation of gloves during surgical procedures is quite common. A cheap and quite effective method of reducing the risk of blood-borne infections is wearing two pairs of gloves. Unfortunately, some surgeons are reluctant to it, and they report decreased dexterity and sensation. The aim of the study was to evaluate surgeons' double-gloving practices to determine the factors related to compliance. <br><b>Material and methods:</b> An anonymous, 21-question survey in Polish was sent by post to 41 surgical departments. The questions concerned: demographic data, type of surgical gloves used, allergy to latex, number of surgeries performed, frequency of using double gloves and negative impressions from using them and finally, the frequency of needlestick injuries during surgical procedures. <br><b>Results:</b> We received 179 questionnaires back. More than 62% of the surgeons believe that double gloves provide better protection than a single pair, 24% do not believe in this, and 14% have no opinion. Only 0.6% of respondents always use double gloves during surgery, 19% double glove in at least 25% of cases and 68% do it occasionally. 13% of the surgeons declared that they had never worn double gloves. During high-risk procedures, 86% of respondents wear double gloves. About half of respondents (50.3%) report discomfort while wearing double gloves; 45% - decreased dexterity; about 30% complain of numbness and tingling; and 64% - decreased sensation. <br><b>Conclusion:</b> Due to the high number of surgical glove perforations and relatively high prevalence of needlestick injuries, it is necessary to use methods that reduce the risk of transmission of pathogens. The habit of using a double pair of gloves should be implemented especially among young surgeons starting to train in their specialities. Consequently, the period of initial discomfort will be combined with the acquisition of surgical skills, which will allow for gradual acclimatization.

Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians.

BACKGROUND: The risk of healthcare-acquired infection increases during outbreaks of novel infectious diseases. Emergency department (ED) clinicians are at high risk of exposure to both these and common communicable diseases. Personal protective equipment (PPE) is recommended to protect clinicians from acquiring, or becoming vectors of, infection, yet compliance is typically sub-optimal. Little is known about factors that influence use of PPE-specifically gloves and masks-during routine care in the ED. METHODS: This was an ethnographic study, incorporating documentation review, field observations and interviews. The theoretical domains framework (TDF) was used to aid thematic analysis and identify relevant enablers of and barriers to optimal PPE use. RESULTS: Thirty-one behavioural themes were identified that influenced participants' use of masks and gloves. There were significant differences, namely: more reported enablers of glove use vs more barriers to mask use. Reasons included more positive unit culture towards glove use, and lower perception of risk via facial contamination. CONCLUSION: Emerging infectious diseases, spread (among other routes) by respiratory droplets, have caused global outbreaks. Emergency clinicians should ensure that, as with gloves, the use of masks is incorporated into routine cares where appropriate. Further research which examines items of PPE independently is warranted.

Effectiveness and safety of surgical glove compression therapy as a prophylactic method against nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy.

BACKGROUND: We have developed a surgical glove (SG)-compression therapy and reported that this method significantly reduced the overall occurrence of grade 2 or higher nanoparticle albumin-bound-paclitaxel (nab-PTX)-induced peripheral neuropathy (PN) from 76.1% to 21.4%. In this multicenter single-arm confirmatory study, we investigated the efficacy and safety of SG-compression therapy for the prevention of nab-PTX-induced PN, compared with the incidence of grade 2 or higher PN in published literature as controls. PATIENTS AND METHODS: Primary breast cancer patients who received 260 mg/m2 of nab-PTX were eligible for this study. Patients wore two SGs (one size smaller than the tight-fitting size) in each hand for 90 min. PN was evaluated at each treatment cycle using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and the Patient Neurotoxicity Questionnaire (PNQ). The temperature of each fingertip was measured using thermography. RESULTS: Between October 2016 and June 2017, 58 patients were evaluated. The incidence of CTCAE grade 2 or higher PN was as low as 13.8% following SG-compression therapy. A goodness-of-fit test proved that the overall incidence of 13.8% grade 2 or higher PN in this study was comparable to the hypothesis-predicted value (13%). No adverse events, including compression intolerance or skin disorders caused by use of SG, were observed. SG-compression therapy significantly reduced the temperature of each fingertip by 1.3°C-2.3 °C compared to pre-chemotherapy level. CONCLUSIONS: This study suggested the safety and efficacy of SG-compression therapy for the amelioration of CIPN. CLINICAL TRIAL NUMBER: UMIN 000024836.

Hand hygiene before donning nonsterile gloves: Healthcareworkers' beliefs and practices.

BACKGROUND: Understanding the perceptions and beliefs of health care workers (HCWs) regarding glove use and associated hand hygiene (HH) may be informative and ultimately improve practice. Research in this area is limited. This study examined the practices and beliefs of HCWs surrounding the use of nonsterile gloves and HH before gloving. METHODS: The study was conducted at 3 large academic US hospitals using a parallel convergent mixed-method design. To estimate compliance rates, the gloving and HH practices of HCWs were observed at entry to patient rooms for 6 months. Interviews were conducted with 25 providers, nurses, and nursing assistants to investigate their beliefs and perceptions of these practices. RESULTS: Observed HH compliance rates before gloving were 42%, yet in the interviews most HCWs reported 100% compliance. Observed compliance with gloving before entering contact precaution rooms was 78%, although all HCWs reported always gloving for standard and contact precautions. Most HCWs described using gloves more often than necessary. HCWs generally use gloves for their own safety and sanitize hands before gloving for patient safety. Numerous barriers to compliance with HH before gloving were discussed, including beliefs that gloves provide enough protection. CONCLUSIONS: HH and glove use are highly intertwined in clinical practice and should be considered jointly in infection prevention improvement efforts.

Factors Influencing Surgeons' Double-Gloving Practice.

BACKGROUND: We sought to evaluate the practice of double gloving among surgeons and to determine the factors that affect compliance with such practice at King Abdulaziz University Hospital (KAUH). METHODS: A survey was conducted among surgeons in active training from all departments at KAUH through the use of a questionnaire from May through July 2017. RESULTS: Of the 220 surgeons who worked at KAUH, 183 agreed to participate in the study for a response rate of 83.2%. Less than half of the respondents (44.3%) stated that they wear double gloves. The main reason for wearing them was "self-protection" (63%), whereas the main reason for not wearing them was that they "think it is required only for special cases" (62.7%). The association between wearing double gloves and the subspecialty was significant (p = 0.033), the highest rate being found among orthopedic surgeons. Among those who usually double glove 84% of needle-prick injuries occurred when they were not double gloved. Eighty percent of needle-prick injuries occurred while surgeons were wearing single gloves. CONCLUSIONS: Less than half of the respondents practice double gloving, the main reason being self-protection. The most common reason for not wearing them was that they are required only for special cases. There was notable association between wearing double gloves and orthopedic surgery. Most needle-prick injuries occurred while wearing single gloves. We believe increasing awareness of the benefits of double gloving might change the practice.

Latex glove use among healthcare workers in Australia.

BACKGROUND: Exposure to natural rubber latex, primarily through the use of gloves, is a well-recognized cause of occupational asthma. We investigated latex glove use among Australian workers and estimated the resultant burden of occupational asthma among healthcare workers (HCWs). METHODS: Data were collected in 2014 as part of the Australian Work Exposures Study-Asthma, a telephone survey investigating the prevalence of current occupational exposure to asthmagens, including latex. We estimated adjusted prevalence ratios (aPRs) to determine variables associated with the use of latex gloves among HCWs and calculated the asthma-related disability-adjusted life years due to latex exposure among HCWs. RESULTS: Latex gloves were used by 22% of respondents. Almost two-thirds (63%) of HCWs reported wearing latex gloves, with 26% using powdered latex gloves. The use of latex gloves was more common among those employed in micro companies (less than 5 employees) than large companies (200+ employees) (aPR = 1.5, 95% confidence interval 1.1-2.0). Latex exposure in HCWs was estimated to contribute 3% of the total asthma-related burden. DISCUSSION: Latex gloves are widely used by Australian workers and by HCWs in particular. CONCLUSIONS: This is the first estimate of the burden of asthma attributable to occupational exposure to latex among HCWs. These results can be used to guide decisions regarding the control of occupational exposure to latex.

Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments.

BACKGROUND: During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area. AIM: To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness. METHODS: Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands. FINDINGS: Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001). CONCLUSION: Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

The Effects of Double Gloving on Microsurgical Skills.

Objective To determine whether double gloving would negatively affect participants' ability to perform a simulated microsurgical task. Study Design Randomized single-blinded controlled crossover trial. Setting Temporal bone laboratory of an academic otolaryngology department. Subjects and Methods This study involved the simulated insertion of a stapes prosthesis into a model of the ossicular chain under microscopy. Forty-one participants were recruited from our medical and dental school and randomized into 2 groups. All groups began by performing the task without gloves, acting as their own control arm. The first group (A) then performed the task with a single pair of gloves while the second group (B) next performed the task with 2 pairs of gloves. The groups then switched gloving methods. The total time taken to perform the task was recorded for each participant and the results subjected to a series of statistical measures. Results This study found a statistically significant difference in the average time taken to complete the task between the "no-glove" arm of the study and both experimental groups but no difference between the 2 experimental groups. Likewise, no significant difference was found between the 2 experimental groups when comparing the rate at which they improved at performing the task. Conclusion These data suggest that wearing 2 pairs of surgical gloves does not negatively affect the speed at which a microsurgical procedure may be performed, lending support to the practice of double gloving, even in the setting of microsurgical fine motor tasks.

Self-reported behaviors and perceptions of Australian paramedics in relation to hand hygiene and gloving practices in paramedic-led health care.

BACKGROUND: Noncompliance with recommended hand hygiene and gloving practices by workers in the emergency medical services may contribute to the transmission of health care-associated infections and lead to poor patient outcomes. The aim of this study was to explore the self-reported behaviors and perceptions of Australian paramedics in relation to their hand hygiene and gloving practices in paramedic-led health care. METHODS: A national online survey (n = 417; 17% response rate) and 2 semistructured focus groups (6 per group) were conducted with members of Paramedics Australasia. RESULTS: Although most of the study participants perceived hand hygiene and gloving to be important, the findings suggest poor compliance with both practices, particularly during emergency cases. All participants reported wearing gloves throughout a clinical case, changing them either at the completion of patient care or when visibly soiled or broken. Hand hygiene was missed at defined moments during patient care, possibly from the misuse of gloves. CONCLUSIONS: Paramedic hand hygiene and gloving practices require substantial improvement to lower potential transmission of pathogens and improve patient safety and clinical care. Further research is recommended to explore how to alleviate the barriers to performing in-field hand hygiene and the misuse of gloves during paramedic-led health care.

Applying human factors and ergonomics to the misuse of nonsterile clinical gloves in acute care.

BACKGROUND: Health care workers (HCWs) are recommended to wear nonsterile clinical gloves (NSCG) for direct contact with blood and body fluids. However, there is evidence of extensive inappropriate NSCG use. METHODS: A mixed-methods study comprising observation of NSCG use in 2 acute hospitals and semistructured HCW interviews. Qualitative data were categorized using thematic analysis. Findings were mapped to the Systems Engineering Initiative for Patient Safety model and used to develop a strategy for improving NSCG use. RESULTS: Two hundred seventy-eight procedures performed in 178 episodes of care involved the use of NSCG. NSCG were inappropriate for 59% of procedures (165 out of 278). Risk of cross-contamination occurred in 49% (87 out of 178) episodes. Twenty-six HCWs were interviewed; emotion and socialization were key factors influencing decisions to use NSCG. Data from observation and thematic analysis were mapped to 6 interacting components of the Systems Engineering Initiative for Patient Safety work system. Interventions targeting each component informed quality improvement strategies CONCLUSIONS: Despite intense promotion of hand hygiene as the key measure to protect patients from health care-associated infection, NSCG dominate routine clinical practice and potential cross-contamination occurs in 50% of care episodes. Such practice is associated with significant environmental and financial costs and adversely affects patient safety. The application of human factors and ergonomics to the complex drivers of inappropriate NSCG behavior may be more effective than conventional approaches of education and policy in achieving the goal of preventing health care-associated infection and improving patient safety.

Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia.

BACKGROUND: Surgical glove perforation is a common event. The operating staff is not aware of the perforation until the procedure is complete, sometimes in as high as 70% of the incidences. Data from Ethiopia indicates that the surgical workforce suffers from a very surgery related accidents, however there is paucity of data regarding surgical glove perforation. The main objective is to describe the incidence and patterns of surgical glove perforation during surgical procedures and to compare the rates between emergency and elective surgeries at one of the main hospitals in Addis Ababa Ethiopia. METHODS: This is a prospective study, performed at the Minilik II referral hospital, Addis Ababa. All surgical gloves worn during all major surgical procedures (Emergency and Elective) from June 1-July 20, 2016 were collected and used for the study. Standardised visual and hydro insufflation techniques were used to test the gloves for perforations. Parameters recorded included type of procedure performed, number of perforations, localisation of perforation and the roles of the surgical team. RESULTS: A total of 2634 gloves were tested, 1588 from elective and 1026 from emergency procedures. The total rate of perforation in emergency procedures was 41.4%, while perforation in elective surgeries was 30.0%. A statistically significant difference (P < 0.05) was found in between emergency and elective surgeries. There were a very high rate of perforations of gloves among first surgeons 40.6% and scrub nurses 38.8% during elective procedures and among first surgeons (60.14%), and second assistants (53.0%) during emergency surgeries. Only 0.4% of inner gloves were perforated. The left hand, the left index finger and thumb were the most commonly perforated parts of the glove. Glove perforation rate was low among consultant surgeons than residents. CONCLUSIONS: Our reported perforation rate is higher than most publications, and this shows that the surgical workforce in Ethiopia is under a clear and present threat. Measures such as double gloving seems to have effectively prevented cutaneous blood exposure and thus should become a routine for all surgical procedures. Manufacturing related defects and faults in glove quality may also be contributing factors.

Prevention of Cardiac Implantable Electronic Device Infections: Single Operator Technique with Use of Povidone-Iodine, Double Gloving, Meticulous Aseptic/Antiseptic Measures and Antibiotic Prophylaxis.

BACKGROUND: Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection-preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. METHODS: A meticulous search for and treatment of active, occult, or smoldering infection was undertaken preoperatively. An aseptic/antiseptic technique was used for implantation of each device. Skin preparation is thorough with initial cleansing performed with alcohol followed by povidone-iodine 10% solution, which is also used in the wound and inside the pocket. In addition, we routinely use double gloving, and IV antibiotic prophylaxis 1 hour before and for 48 hours afterwards followed by oral antibiotic for 2-3 days after discharge. The skin is closed with absorbable sutures. The study includes 382 patients having a new pacemaker (n = 333) or battery change, system upgrade or lead revision (n = 49), and 380 patients having a new implantable cardioverter-defibrillator (ICD) (n = 296) or device replacement/upgrade/lead revision (n = 84). RESULTS: The pacemaker group, aged 70.2 ± 16.5 years, includes 18% VVI, 49% DDD, 29% VDD, and 4% cardiac resynchronization therapy (CRT) devices. The ICD group, aged 61.3 ± 13.0 years, with a mean ejection fraction of 36 ± 13%, includes 325 ICD and 55 CRT implants. Over 26.6 ± 33.4 months for the pacemaker group and 36.6 ± 38.3 months for the ICD group, infection occurred in one patient in each group (0.26%) having a device replacement. CONCLUSION: A consistent and strict approach of aseptic/antiseptic technique with the use of double gloving and povidone-iodine solution within the pocket plus a 4-day regimen of antibiotic prophylaxis minimizes infections in CIED implants.

Utilização das luvas na prática de enfermagem e suas implicações: estudo metodológico / Glove use in nursing practice and its implications: a methodological study / Utilización de los guantes en la práctica de enfermería y sus implicaciones: estudio metodológico

Este artigo originou-se da segunda categoria que emergiu na Dissertação de Mestrado Profissional intitulada "Tecnologia educacional como estratégia para o uso de luvas pelos profissionais de Enfermagem visando a precaução de contato",apresentada à banca examinadora da Escola de Enfermagem Aurora de Afonso Costa (UFF). OBJETIVO: identificar os fatores que interferem na adesão e/ou adequação às medidas de precaução de contato na utilização das luvas de procedimentos e estéreis pela equipe de enfermagem. MÉTODO: estudo metodológico com abordagem quantiqualitativa. Com um total de 66 participantes distribuídos em 4 etapas. NA 1ª etapa, foram entrevistados 45 profissionais de enfermagem das clínicas cirúrgicas em um hospital universitário entre janeiro e março de 2014. RESULTADOS: 93% dos profissionais apontam falhas no uso de luvas, e somente 7% não observam falhas. CONCLUSÃO: a adequação no uso de luvas é determinante para a segurança do paciente, do profissional, da sociedade e do ambiente.

This article originated from the second category that emerged on the professional master's dissertation entitled "Educational technology as a strategy for the use of gloves by nursing professionals aiming the contact precaution", presented to the Review Board of the nursing school Aurora de Afonso Costa, Universidade Federal Fluminense (UFF ­ Fluminense Federal University). AIM: to identify the factors that interfere in the adhesion and/or adequacy of the precautionary contact measures in the use of procedure sterile gloves by the nursing team. METHOD: this is a methodological study using a quantitative approach, with a total of 66 participants distributed in four stages. In the first stage, 45 nursing professionals from the surgical clinics were interviewed in a university hospital between January and March 2014. RESULTS: 93% of the professionals report a failure in the use of gloves and only 7% do not observe failures. CONCLUSION: the suitability of gloves is crucial for the safety of patients, professionals, society and the environment.

Este artículo se originó de la segunda categoría que surgió en laDisertación de Maestría Profesional titulada "Tecnología educacional como estrategia para el uso de guantes por los profesionales de Enfermería buscando la precaución de contacto", presentada a la banca examinadora de la E scuela de E nfermería A urora de Afonso Costa (UFF). OBJETIVO: identificar los factores que interfieren en la adhesión y/o adecuación a las medidas de precaución de contacto en la utilización de los guantes de procedimientos y estériles por el equipo de enfermería. MÉTODO: estudio metodológico con abordaje cuanticualitativo. Con un total de 66 participantes distribuidos en 4 etapas. En la 1ª etapa, fueron entrevistados 45 profesionales de enfermería de las clínicas quirúrgicas en un hospital universitario entre enero y marzo de 2014. RESULTADOS: 93% de los profesionales apuntan fallas en el uso de guantes, y solamente 7% no observan fallas. CONCLUSIÓN: la adecuación en el uso de guantes es determinante para la seguridad del paciente, del profesional, de la sociedad y del ambiente.

Factors associated with variability in management of vascular access ports.

Guidelines and clinical practice recommendations vary on the management of vascular access ports. Traditionally, patient, health system and healthcare professional's factors have been interrelated in studies of clinical practice variability. Understanding variation in the management of vascular access ports and to identify the influence of these factors in the compliance with the most common recommendations of vascular access guidelines, is an important first step for designing targeted improvement interventions. We analysed data from a survey sent to all Spanish outpatient clinics. Overall, 185 units at Spanish outpatients clinics out of a total of 256 completed the survey. Geographical region and unit size are the most common associated factors in the management of vascular access ports and there is a low level of compliance with many of the recommendations given by guidelines. Large outpatient chemotherapy units have been related to higher monitoring of the recommendations. Clinical practice and provided care to patients with vascular access ports are influenced by region and structural and organisational differences in the outpatient chemotherapy units. It is important to identify additional factors that may explain the variability.

[Use of Reusable Textile Undergloves for Medical Procedures: A Feasibility Study]. / Einsatz wiederaufbereitbarer textiler Unterziehhandschuhe für medizinische Tätigkeiten: eine Machbarkeitsstudie.

OBJECTIVE: Undergloves are a way to reduce moisture-related skin damage. The aim of this feasibility study was to gain experience with logistics, applicability, acceptability and cost of the routine use of reusable textile undergloves in a hospital setting. METHODS: Undergloves were tested with 18 health-care workers on an intensive care unit over three months. Data on usage as well as logistics were recorded. At baseline, personal data and knowledge and use of cotton undergloves, existing skin problems and the nursing behaviour of the hands by the subjects were determined by means of an input questionnaire. After each wearing, data on usage were collected by a questionnaire. Participants were interviewed by means of a questionnaire with respect to their experience with the use of the undergloves. RESULTS: Acceptance and compliance with the use of undergloves was remarkably good. This was partly due to the properties of the gloves, and partly to the reduction of sweating and very positive effect on the skin of the hands. In the study period 2165 underglove uses were documented, resulting in an average daily consumption of four pairs per person per day. The average wearing time was 28.6 min. The undergloves were suitable for application as well as reprocessing. Reprocessment-related fatigue was relatively low and did not lead to the loss of the properties, only few gloves had to be sorted out. Even if one assumes a complete write-off of the gloves with end of the study, costs for reprocessing were about 0.46 € or 64 % less than the single use. CONCLUSION: The routine use of textile, reprocessable undergloves is feasible. Major challenges for broad usage are within logistics and acceptance by the user.

Knowledge, attitudes and practice of dentists concerning the occupational risks of hepatitis B virus in Al Jouf Province, Saudi Arabia.

INTRODUCTION: Hepatitis B virus (HBV) is a well-recognized occupational risk for all health care workers (HCWs) worldwide. In Saudi Arabia, very little is known about knowledge, attitudes, and practice of dentists toward occupational risk of HBV. Our study was conducted to assess the same parameters. METHODS: During February 2012, a cross-sectional survey of 48 dentists with mean age 38 ± 11.2 years was carried out at the primary health care centers in Al Jouf Province of Saudi Arabia. The dentists were asked to fill a valid questionnaire containing their socio-demographic data, and well-designed questions about their knowledge base, attitudes and practice toward occupational risk of HBV. The data were processed and analyzed using the SPSS (version 17) (IBM SPSS Inc., Chicago, IL, USA) program and the level of significance were set at P < 0.05. RESULTS: Response rate of 85.4% yielded 41 questionnaires for analysis. Majority of the dentists surveyed 34 (82.9%) perceived that they are at high risk of contracting and spreading HBV, and 28 (68.3%) had a concern to get HBV. More than half 23 (56.1%) were willing to achieve continuity of care for HBsAg-positive patients. The vast majority 39 (95.1%) believed that HBV vaccine is safe, and 34 (82.9%) were vaccinated. Less than half 17 (41.5%) recognized that HBV is resistant to alcohol and some detergents. During surgical procedures, only 14 (34.1%) always use double gloves and 19 (46.3%) always use goggles. Almost all dentists surveyed were willing to subscribe in a regular training programs about HBV. CONCLUSION: More education focusing on occupational risk of HBV is recommended for dentists.

Status of hepatitis B vaccination among surgeons practicing in Ethiopia: a cross sectional study.

BACKGROUND: Hepatitis B virus (HBV) is a well recognized but under emphasized occupational health hazard in Ethiopia. OBJECTIVES: To assess the vaccination status against Hepatitis B among surgeons practicing in Ethiopia and the reasons for poor adherence to vaccinations. METHODS: A structured questionnaire was developed using the Qualtrics Survey free software tool and sent to 131 surgeons and surgical residents practicing in 28 hospitals. 98 completed and submitted the online survey. The main outcome measures were vaccination status, recent occupational accidents and reasons for non-vaccination. RESULT: Ninety-four (95.9%) of the respondents were males, Only 24 (23.5%) were vaccinated against HBV, 18/24 (75%) of whom received the three recommended doses. The main reasons for non vaccination is lack of knowledge about the availability of the vaccine in the country, lack of time and mere negligence. Differences in age, sex, and duration of practice, field of specialty and respondent's institution between vaccinated and unvaccinated were not significant (P > 0.05). Ninety-two (93.9%) believe the vaccination is very useful for the surgeon. 86.4% of the respondents claim they wear double gloves in more than 50% of their operations while 76 (77.6%) had sustained sharp injury over the past one year. 13 (13.25%) of the respondents had taken ART prophylaxis in the past. CONCLUSION: Despite their strong belief that HBV vaccine is useful, most surgeons are still not vaccinated. As occupational injuries are very common, Hepatitis B vaccination should be a prerequisite for working in the theatre, hence putting the surgeons and surgical patients at reduced risk.

Comparison of compliance of glove use among anesthesia providers: a prospective blinded observational study.

Compliance of using gloves in the operating room (OR) is still poor amongst anesthesia providers. The practice of using gloves amongst OR anesthesia providers (attending anesthesiologists, anesthesia nurses, and trainees) in a tertiary care center was observed over 8 months. Observations were made during intravenous (IV) cannulations, laryngeal mask airway (LMA)/endotracheal tube (ETT) introductions, and ETT extubation/LMA removals, without alerting anesthesia personnel. Ten observations were made from each of the procedures for every provider involved. 1,240 observations were made involving 8 attending anesthesiologists, 9 trainees, and 14 nurses. A Chi-square test showed significant difference of glove utilization rates between the groups during all 4 procedures. The highest compliance was observed in trainees (50%), followed by nurses (39.64%), and attending anesthesiologists (10.93%). All groups had their highest compliance levels during IV cannulation. Additionally, attending anesthesiologists had the lowest compliance levels during all individual procedures. Anesthesia nurses had the highest compliance during LMA removals (39.29%), whereas trainees showed the highest compliance in all other procedures. Glove usage by anesthesia providers during routine OR procedures continues to be low. Educational programs highlighting the hazards of noncompliance and strict departmental protocols may help to eliminate irregularities in the use of gloves.

Needlestick fluid transmission through surgical gloves of the same thickness.

BACKGROUND: Using two gloves during surgical procedures is more protective than one in relation to percutaneous needle injuries, but it remains unclear whether the use of two thin-walled gloves is equally as protective as a single thicker-walled glove. AIMS: To compare the volume of contaminant transmitted from fluid-coated solid cutting suture needles through the same thickness of the same glove material made up of differing numbers of layers during simulated needlestick injuries. METHODS: A colorimetric enzyme assay was used to determine the volume of fluid transferred through identical glove materials in mechanized simulated needlestick injuries. The needles were mechanically transferred through varying glove layers [zero (control), one and two] where the cumulative thickness of the double layer was equal to the single thicker layer. The force required to puncture the test mater ials was also recorded. RESULTS: In simulated 'needlestick' injury experiments, significantly less fluid was transmitted through the double, thin glove layer compared with the single thick layer (P < 0.05). The double, thin glove layer transmitted 16% of needle fluid compared with 21% for the single thicker glove layer. Significantly more force was required to puncture the double layer compared with the single thicker layer (P < 0.05), but for any individual puncture there was no association between the puncture force and the volume of fluid transmitted. CONCLUSIONS: A double layer of glove material was more resistant to puncture and removed more enzyme contaminant from a solid cutting suture needle compared with an equivalent single thick layer of glove material.