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Use of Gloves and Reduction of Risk of Injury Caused by Needles or Sharp Medical Devices in Healthcare Workers: Results from a Case-Crossover Study

Published online by Cambridge University Press:  02 January 2015

Laura M. Kinlin ,
Murray A. Mittleman ,
Anthony D. Harris ,
Michael A. Rubin  and
David N. Fisman
Laura M. Kinlin
Affiliation:
Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Murray A. Mittleman
Affiliation:
Harvard School of Public Health, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Anthony D. Harris
Affiliation:
University of Maryland School of Medicine, Baltimore
Michael A. Rubin
Affiliation:
University of Utah School of Medicine, Salt Lake City
David N. Fisman*
Affiliation:
Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Departments of Health Policy, Evaluation and Management, and Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
*
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 678, Toronto, Ontario, CanadaM5T 3M7 (david.fisman@utoronto xa)
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Abstract

Objective.

Standard precautions are advocated for reducing the number of injuries caused by needles and sharp medical devices (“sharps injuries”), but the effectiveness of gloves in preventing such injuries has not been established. We evaluated factors associated with gloving practices and identified associations between gloving practices and sharps-injury risk.

Design.

Usual-frequency case-crossover study.

Setting.

Thirteen medical centers in the United States and Canada.

Participants.

Six hundred thirty-six healthcare workers who presented to employee health clinics after sharps injury.

Methods.

Structured telephone questionnaires were administered to assess usual behaviors and circumstances at the time of injury.

Results.

Of 636 injured healthcare workers, 195 were scrubbed in an operating room or procedure suite when injured, and 441 were injured elsewhere. Nonscrubbed individuals were more commonly gloved when treating patients who were perceived to have a high risk of human immunodeficiency virus, hepatitis B virus, or hepatitis C virus infection than when treating other patients (adjusted odds ratio [aOR], 2.53 [95% confidence interval {CI}, 1.30-4.91]). Nurses (aOR, 0.11 [95% CI, 0.04-0.32]) and other employees (aOR, 0.24 [95% CI, 0.07-0.77]) were less commonly gloved at injury than were physicians and physician trainees. Gloves reduced injury risk in case-crossover analyses (incidence rate ratio [IRR], 0.33 [95% CI, 0.22-0.50]). In scrubbed individuals, involvement in an orthopedic procedure was associated with double gloving at injury (aOR, 13.7 [95% CI, 4.55-41.3]); this gloving practice was associated with decreased injury risk (IRR, 0.20 [95% CI, 0.10-0.42]).

Conclusions.

Although the use of gloves reduces the risk of sharps injuries in health care, use among healthcare workers is inconsistent and may be influenced by risk perception and healthcare culture. Glove use should be emphasized as a key element of multimodal sharps-injury reduction programs.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 9 , September 2010 , pp. 908 - 917
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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