How To Complete A Risk Assessment For The Appropriate Use Of Examination Gloves In Care Environments

Since the late 1980s’, the practice of using protective gloves has become part of everyday nursing home life, ensuring healthcare staff and those being cared for are protected from contracting infections via micro-organisms transmitted during certain skin-to-skin contact.

When Gloves Must Be Worn

Gloves MUST be worn when there is a likelihood of hand contact or exposure to:

• Blood
• Body fluids
• Hazardous substances
• Non-intact skin or mucous membranes
• When handling contaminated items or surfaces

HOWEVER, gloves should not be worn unnecessarily, as their prolonged and indiscriminate use may cause adverse reactions and skin sensitivity. (Department of Health Standard Principles for the Use of Personal Protective Equipment 2001).

Assessing The Risks

Prior to undertaking any client procedure or contact with hazardous substances, a risk assessment should be carried out to establish whether or not there is a need for personal protection such as gloves. The following questions should be considered before selecting glove type:

• • • Who is at risk (patient or staff)?
    • Is contact likely with blood, body fluids or substances hazardous to health?
      • If No, personal protection is not required.
      • If Yes, then personal protection is required, and consideration must be given to whether sterile or non-sterile gloves are required.
    • What is the barrier efficacy of the glove?
    • Does the member of staff or patient have any allergies?

The Health & Safety Executive state ‘in many situations a risk-assessment will suggest that in the presence of a risk of blood-borne pathogen transmission, for example surgery and body fluid contact, NRL (natural rubber latex) is the safest choice of material provided the worker and patient are not sensitised to this. However, due to the increasing incidence of allergic reactions to medical gloves it is important to carry out a risk assessment. This ensures that the right glove for the task is chosen and minimises potential risk to patients.

It is important to note that the recommendation is to not use latex disposable gloves as reactions to latex proteins can develop over time therefore the simple removal of latex from the care environment is the best option.

If a person is sensitised to NRL proteins, NRL-free gloves and equipment must be used. Not all NRL free gloves afford the same protection against blood-borne pathogens, so care must be taken in the choice of substitutes. Some gloves may only be suitable for non-clinical tasks as they may not afford the same level of protection against transmission of blood-borne pathogens.

If there is doubt, suppliers must be asked to provide test data to prove the gloves suitability. ‘Vinyl gloves are not an effective substitute for latex due to their limited strength and potential risks of the vinyl gloves leaking (ICNA glove usage guidelines)’.

‘Healthcare establishments are advised to develop a policy to address the purchase and safe use of gloves within their establishments’. (Medical Devices Agency)

Recently an NHS nurse won substantial damages from a Scottish hospital board because gloves in her workplace caused her a severe allergic reaction.

Look out for our next article in the series next week, High Risk v Low Risk, which glove to choose and why.