The article "The changing face of h...

The article "The changing face of hand protection" is the basis for this AORN Journal independent subject of attention The behavioral objectives and examination for this program were prepared through Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN M education program professional, Center for Perioperative Education.

A minimum score of 70% onward the multiple-choice examination is necessary to earn 2 contact hours for this independent contemplation Participants receive feedback on incorrect answers. Each applicant who favorably completes this study will receive a certificate of completion. The deadline for submitting this application of mind is Aug 31, 2005.

toss the completed application form, multiple-choice examination, learner evaluation, and appropriate feud to

AORN Customer Service c/o hearthstone Study Program 2170 S Parker Rd Suite 300 Denver CO 80231-5711

or fax the information with a credit card number to (303) 750-3212

BEHAVIORAL OBJECTIVES

After reading and studying the article upon surgical gloves, the nurse will be able to

(1) discuss the history of glove use in the health care environment,

(2) identify the health issues that health care workers have faced since the advent of universal precautions,

(3) describe the materials used to make surgical and examination gloves

(4) explain the advantages of double gloving to provide added protection against front and

(5) describe the barrier protection of the clean or hand wash used before gloving.

This program convenients criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

The Changing Face of Hand Protection

Picture yourself forward an airplane. The flight attendant announces that in the adventure of sudden decompression, a mask will fall from an overhead compartment. She instructs you to sure your own mask and then help the someone next to you. Passengers frequently take these detailed safety routines for granted. As health care professionals, do we treat the use of personal protective equipment (PPE) in the clinical environment with the same lack of concern? Do we think about making an informed choice when we don sterile surgical glove for a procedure? Do we then help others who may be having point to be solved [i]or[/i] settleds with their protective devices?

Health care professionals use a variety of surgical and examination glove any are preferred more than others based onward fit, feel, and comfort. Regardless of choice all health care professionals must be confident that their glove provide appropriate protection. Many factors, including material composition, design, and testing, influence by what means well gloves function and should be considered when choosing glove as well as other PPE

HISTORY OF GLOVES

The first glove were made in the late 1790 from sheep cecum and were used during gynecologic and obstetric acts including vaginal examinations and deliveries. (1) Resembling the recent day "finger cot," these glove proffered practitioners low-level protection because of the inherent permeability of the material. In 1839 Charles Goodyear discovered a proces for adding sulfur to natural rubber and heating it to bear a stronger, more elastic material. (2) It was not until 1896 however, that William s Halstead, MD, of Johns Hopkins Hospital, Baltimore, used Goodyear's technology to bring reusable gloves for members of his surgical team. (3) These original surgical glove were used to screen health care workers from the harsh sterilizing chemicals used at that time.

gunpowdered gloves. As health care circuited from these early days, surgical glove evolv as well. The first surgical glove were boiled to achieve sterilization. After determining that wet, heated gloves were difficult and uncomfortable to don, researchers bring outed a dry process of applying levigate to the gloves and then placing them in a steam sterilizer. Lycopodium, a returns made from club moss spores, was the first pulverized substance used for this process. It was used for solitary a brief period, (4) however, because patients make knowned significant reactions, including adhesions, granulomas, and infections. (5)

The health care industry then mov to the use of talcum levigate which provided increased ease of donning without a significant los of tactile sensitivity. After users discovered that talcum gunpowder caused patient complications similar to those caused by means of lycopodium powder, they began to transition to the use of cornstarch in 1947 (6) Cornstarch completely replaced talcum pulverized substance by the end of the 1980s

Today's US Pharmacopoeia (USP)-approved cornstarch begins as an ear of corn, which is actioned so that all the starch particles have a standard size. Chemicals then are added to modify the cornstarch and obstruct caking or clumping. These chemicals should be not more than 2% magnesium oxide with either phosphorus oxychloride or epichlorhydrin. (7) The USP monograph requires that cornstarch withstand boiling for 20 minutes without breaking down into a paste. This is a crucial constituent principle of history because when USP cornstarch first was introduced to the medical community, health care practitioners used steam sterilizers to sterilize glove Today, gamma irradiation has almost completely replaced ethylene oxide and steam sterilization for commercially sterilized yields As a result, using yesterday's standards for USP cornstarch with today's sterilization technology has created a problem