Needlestick injuries are a persistent problem in the OR, but double gloving can help

Needlesticks and other sharps injuries continue to be a concern for healthcare workers. The International Safety Center has found that more than half of sharps injuries involve devices lacking sharps injury protection (SIP) features and the greatest percentage of all sharps injuries occur in the operating room.

Becker's Hospital Review recently spoke with Lorrie Calabrese, BSN, RN, CNOR clinical nurse consultant at Mölnlycke, about sharps safety. She shared best practices for mitigating the risk of needlestick injuries and discussed the need for cultural change around sharps safety, particularly among surgeons and OR teams.

Multiple measures are needed to improve sharps safety
Needlesticks and other sharps injuries are an occupational hazard for all healthcare employees. “Today, the greatest risk of disease from sharps injuries is acquiring hepatitis B or hepatitis C,” Ms. Calabrese said. “Facility-based prevention measures based on clinical specialty are important, as is a hierarchy of controls.”

A hierarchy of controls may include wearing personal protective equipment correctly, selecting the right needle gauge and length, evaluating suture needles, using scalpels with retracting blades and handles, implementing no-hands passing to protect surgical team members and utilizing devices with SIP features like needles that retract or are covered by a shield. 

Double gloving is highly effective for protecting healthcare workers from needlestick injuries
When it comes to surgical teams in the OR, double gloving is one of the most important best practices for sharps safety. “One study found that 99 percent of surgical residents had a needlestick injury by their final year of training, but only around half of those incidents were reported,” Ms. Calabrese said. “The encouraging news, however, is that another research team discovered that double gloving decreases the risk of exposure to patient blood by as much as 85 percent. This study also found that when a solid suture needle passes through two glove layers, the amount of blood on the needle is reduced by as much as 95 percent, which reduces the viral load.

A best practice when double gloving is to use a proven indicator system; that is, two gloves that are engineered to work together to maximize the speed of identifying a breach in the outer glove. Mölnlycke’s Biogel® Puncture Indication® SystemTM, for example, detects 97 percent of glove perforations. In a US-based study across five facilities measuring in-use failure rates, non-Biogel gloves were at least 3.5 times as likely to fail as Biogel gloves.

When implementing double-gloving protocols, healthcare organizations must select gloves based on factors like strength, durability, thickness and other features like color indicators. Staff are often more willing to accept double- gloving protocols when they have a choice of gloves. Biogel gloves, for example, are available in a full line including straight, curved and biomechanically optimized options.

“One combination of double gloves may not be best for everyone, since everyone’s anatomy is different,” Ms. Calabrese said. “Some organizations hold glove fairs, so their staff can try gloves on, experiment and become acclimated to double gloving. Encourage your staff to try different combinations to find what feels right for them. The goal is for clinicians to find a double gloving system that balances protection and tactile sensitivity.”

Cultivating a culture of sharps safety is an ongoing process
To create a culture of sharps safety, leaders must be open, honest and willing to confront this important issue. As healthcare organizations create quality improvement plans around sharps safety and needlestick injuries, it’s essential to involve surgeons, including those who are most resistant to double gloving. Health systems with a culture of sharps safety look for solutions in a non-judgmental atmosphere. 

“Enhancing sharps safety is an ongoing improvement process,” Ms. Calabrese said. “We need to empower our staff to share their personal stories about needlestick injuries and offer their opinions about how their work could be performed differently and more safely.”

This article was sponsored by Molnlycke.

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