The Effectiveness of Sterile Medical Gloves

In past decades, surgical gloves were primarily used to protect patients from iatrogenic infection. More recently, the gloves have served to protect medical staff. As the human immunodeficiency and hepatitis viruses have become more prevalent, the need for an effective mechanical barrier between patients and health care workers has increased considerably. Unfortunately though, ordinary medical gloves do not adequately prevent the transmission of bloodborne pathogens.

It has been estimated that as many as 1.5 million people in the United States alone are already infected with the human immunodeficiency virus (HIV). Moreover, in certain areas, the rate of HIV infection among emergency department patients may be as high as 8 percent. In fact, the rate among urban trauma victims may approach 16 percent. Considering that the complications of acquired immunodeficiency syndrome are always fatal, such high prevalence rates have important implications for health care workers (Eustis, Wright, Wrenn, Fowlie, & Slovis, 1995, pp. 512-515).

There are three basic steps in the development of any infectious disease. These include the following: (1) contamination; (2) infection; and (3) pathologic effect (Miller & Palenik, 1991, pp. 682-684). Of course, exposure to an infectious agent does not always lead to disease. Three factors determine whether or not pathologic consequences will develop subsequent to infectious agent exposure. Thes

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lth care workers themselves. Close visual inspection of the hands may not detect every small cut or abrasion. Furthermore, even a small break in the skin can serve as a "portal of entry for microorganisms into the body" (Miller & Palenik, 1991, pp. 682-684). Olsen et al. (1993) studied 137 procedures during which a health care worker's gloved hand contacted a patient's mucous membrane resulting in possible contamination with gram-negative rods or enterococci. Eighty-six of the 135 gloves cultured were found to have gram-negative rods or enterococci on their external surface subsequent to use. Even when glove leaks were present though, gloving prevented hand contamination 77 percent of the time. Moreover, the quantitative counts of microorganisms on contaminated hands were "2 to 4 logs less than counts on external glove surfaces" (Olsen et al., 1993, pp. 350-353). Thus, the study concluded that under conditions of routine use, gloves effectively function as a protective barrier even when leaks are present. They provide substantial protection to health care workers during hand contact with moist body surfaces containing gram-negative and enterococci. The following general guidelines with respect to glove use are recommend

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