Surgeons are fanatical about their gloves' fit, feel and comfort, but what about their role in infection prevention? Gloves are on the front lines of barrier protection, shielding hands from exposure to blood, mucous membranes and non-intact skin. They decrease the likelihood that staff will transmit their own endogenous body flora to patients. Not just any glove will do, however. You must pick the right glove for the right task. As you'll see in this 8-question quiz, there's significant variability among various glove designs.

1. According to the CDC, which glove material is preferable for clinical procedures that require manual dexterity or involve more than brief patient contact?

a. vinyl
b. polyisoprene
c. latex
d. nitrile
e. both c & d

e. both c & d

It's essential to examine available data on different materials to determine the type of glove that will be the most proficient in meeting the barrier protection needs of each of your staff members in order to prevent infections. "Both the quality of the manufacturing process and type of material influence (a glove's) barrier effectiveness," says the CDC. "While there is little difference in the barrier properties of unused intact gloves, studies have shown repeatedly that vinyl gloves have higher failure rates than latex or nitrile gloves when tested under simulated and actual clinical conditions. For this reason, either latex or nitrile gloves are preferable for clinical procedures that require manual dexterity or will involve more than brief patient contact."

2. The American College of Surgeons states that double-gloving reduces the risk of exposure to patients' blood by as much as ____% when the outer glove is punctured.

a. 17%
b. 47%
c. 69%
d. 87%

d. 87%

The ACS recommends the universal adoption of the double-glove (or underglove) technique in order to reduce body-fluid exposure caused by glove tears and sharps injuries. In addition, the ACS acknowledges that double-gloving protects patients from surgical wound contamination by decreasing the likelihood of sweat spilling from surgeons' gloved hands.

3. What is the "gold standard" glove material for protection from infection?

a. polyisoprene
b. latex
c. nitrile
d. vinyl

b. latex

All gloving materials are benchmarked to latex, which is found to be superior barrier protection in research studies about leakage and perforation rates. Nitrile and neoprene offer the best barrier protection in non-latex gloving materials.

"Although non-latex surgical gloves provide basic barrier protection, the rate at which they break or tear while performing routine surgery makes them inferior to latex surgical gloves. The data clearly supports high-quality surgical latex gloves as the glove material of choice and the use of non-latex gloves for patients and healthcare workers who are allergic to latex," says Denise M. Korniewicz, PhD, RN, FAAN, dean of the University of North Dakota College of Nursing.

4. If you don't have time to wash your hands, make sure you wear gloves, which can replace handwashing requirements.

a. true b. false

b. false

The CDC states, "Wearing gloves does not replace the need for handwashing, because gloves may have small, inapparent defects or may be torn during use, and hands can become contaminated during the removal of gloves." Handwashing is always the first line of defense against infections.

5. What do hand lotions and latex gloves have to do with infection control?

a. the use of hand lotion can decrease microbial dispersion
b. it's important to use non-petroleum lotion when wearing latex gloves so that the barrier protection isn't compromised
c. there's no correlation between hand lotion, latex gloves and barrier protection
d. both a & b
e. none of the above

d. both a & b

"Moisturizing is beneficial for skin health and reducing microbial dispersion from skin, regardless of whether the product used contains an antibacterial ingredient," says Elaine Larson in "Hygiene of the Skin: When Is Clean Too Clean?" in the March-April 2001 issue of the journal Emerging Infectious Disease.

Certain chemicals, however, can diminish the protectiveness of your gloves. Any petroleum dressing or mineral oil can seriously weaken their integrity in a very short time. The National Institute for Occupational Safety and Health's 1997 alert, "Preventing Allergic Reactions to Natural Rubber Latex in the Workplace," offers this advice to reduce the chance of adverse reactions when wearing latex gloves:

• Don't use oil-based hand creams or lotions (which can cause glove deterioration) unless they've been shown to reduce latex-related problems and maintain glove barrier protection.
• Avoid hand creams containing mineral oil, petroleum, lanolin and other oils (palm oil, for example). All these creams contain hydrocarbons, which cause deterioration of the physical and barrier properties of natural rubber latex. Instead, use moisturizers that are water-based or contain sodium lauryl sulfate as the active ingredient. When applied before donning an occlusive glove, this type of lotion doesn't compromise latex properties, and the positive effects include an increased hydration level and water-barrier function of the skin.

6. What are the factors to consider when inspecting gloves before donning to ensure optimal protection?

a. note any signs of glove stains, watermarks, discoloration or white lines
b. look for rips, holes or tears at stress points such as the folds
c. glove shipping and storage integrity, looking for already opened or damaged packages.
d. all of the above

d. all of the above

It's always important to inspect the integrity of your gloves prior to donning them. Note any signs of tampering on glove packages and do not use sterile gloves if the package has been opened or damaged in any way. When you open the package and examine the gloves, look for any signs of stains, watermarks, discoloration, white lines, rips, holes or tears at the stress points or the folds. If you find any of these problems, discard the gloves and get another pair.

7. What's a good way to increase the likelihood of noticing a glove perforation when double-gloving?

a. only wear the most expensive glove available
b. wear a non-latex glove on the bottom and a latex glove on top
c. wear 2 colors of gloves
d. wear the same color of gloves

c. wear 2 colors of gloves

Wearing gloves of 2 different colors significantly enhances the recognition of a perforation in your top glove when double-gloving. "More glove perforations are detected when using a colored underglove indicator system when compared to 2 pairs of standard latex gloves," says AORN.

8. What is the appropriate way to remove and dispose of gloves?

a. remove gloves promptly after use
b. when you remove gloves, ensure that they are inside-out
c. flick, snap and toss your gloves into the garbage
d. a & b
e. all of the above

d. a & b

Make sure that you remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before treating another patient. It is important to turn both gloves inside-out to prevent infectious materials from touching anything. Drop used gloves directly into an appropriate container. Never flick, snap or toss your gloves upon removal and always wash your hands after removing your gloves to limit cross-contamination risks.