Reuse of same gloves after sterile and unsterile procedures by repeated use of handrubs

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Reuse of same gloves after sterile and unsterile procedures by repeated use of handrubs

  1. 1. REUSE OF SAME GLOVES AFTER STERILE AND UNSTERILE PROCEDURES BY REPEATED USE OF HANDRUBS ANITA GEORGE DEPT. OF NEUROSURGERY JPN APEX TRAUMA CENTRE, AIIMS
  2. 2. INTRODUCTION <ul><li>HANDRUB </li></ul><ul><li>Alcohol based liquid hand disinfectant </li></ul><ul><li>Kills a broad range of nosocomial pathogens </li></ul><ul><li>Active against bacteria, fungi & enveloped virus </li></ul><ul><li>Possess an excellent immediate effect </li></ul><ul><li>Excellent skin tolerability with long term use </li></ul>
  3. 3. BACKGROUND OF THE STUDY <ul><li>Nurses have to frequently change the gloves for </li></ul><ul><li>various procedures like suctioning and positioning </li></ul><ul><li>in the same patients as well as between different </li></ul><ul><li>patients(around 10-15 times).So there is a </li></ul><ul><li>tendency to use the same gloves and there is a </li></ul><ul><li>high chance of breach in sterility </li></ul>
  4. 5. BACKGROUND OF THE STUDY Clinical microbial rev,2004 oct:17(4):863-93 NAME AND YEAR STUDY RESULT Kampf G,Kramer A 2004 Epidemologic Background of hand hygiene & evaluation of the most important agents for rubs and scrubs The best antimicrobial activity can be achieved with ethanol(60-85%), isopropanol(60-80%) & n-propanol(60-80%) and the activity is broad and immediate.
  5. 6. BACKGROUND OF THE STUDY cont. Med Princ Pract,2005 sep-oct:14(5):313-7 NAME AND YEAR STUDY RESULT Karabay O et.al. 2005 Compliance and efficacy of handrubbing during in-hospital practice. METHOD Hand cultures were taken before and after procedure. N=35 Handrubbing with alcohol based solutions significantly reduced the bacterial contaminationof the nurses more than handwashing (54 and 27%respectively). Compliance was also better in the handrubbing group than the handwashing group(72.5% and 15.4% respectively;p value=0.001)
  6. 7. OBJECTIVE OF THE STUDY <ul><li>To assess whether used gloves can remain sterile by repeated washing with handrubs . </li></ul>
  7. 8. METHODOLOGY <ul><li>Prospective study carried out in Neurosurgery I.C.U </li></ul><ul><li>over two month period(July-August 2011) </li></ul>N=120 EXPERIMENTAL GROUP-UNSTERILE GLOVES WITH HANDRUB(60) CONTROL GROUP-UNSTERILE GLOVES(60)
  8. 9. STUDY METHOD (CONTROL GROUP) <ul><li>Using convenient sampling, cultures of unsterile gloves were taken by washing gloves with sterile water after performing a nursing procedure(to obtain culture fluid) </li></ul>
  9. 10. UNSTERILE GLOVES WITHOUT HANDRUB
  10. 11. COLLECTION OF THE SAMPLE
  11. 12. STUDY METHOD (EXPERIMENTAL GROUP) <ul><li>Similarly,cultures of glovewashed gloves were taken after glovewashing with handrub and subsequently washing gloves with sterile water to obtain culture fluid(experimental group) </li></ul><ul><li>The culture of the glove wash was taken in MacConkey blood agar media, kept at 37° C for 24 hours. </li></ul>
  12. 13. USED GLOVES WITH HANDRUB
  13. 14. RUBBING THE USED GLOVES
  14. 15. DRYING THE GLOVES
  15. 16. COLLECTION OF THE SAMPLE
  16. 17. DATA ANALYSIS <ul><li>Culture reports were analyzed using Pearson Chi-Square test </li></ul>
  17. 18. RESULTS P VALUE< 0.001 N=120 Culture negative Culture positive CONTROL GROUP(unsterile gloves) 36(60%) 24(40%) EXPERIMENTAL GROUP(unsterile gloves with handrub) 58(96.7%) 2(3.3%)
  18. 19. CONCLUSION <ul><li>.Glovewashing is highly effective in maintaining sterility of gloves </li></ul><ul><li>Therefore the study shows that it may be practical to use used gloves by glovewashing handrub. </li></ul><ul><li>This eventually can reduce the excessive use of sterile gloves which is cost effective </li></ul>
  19. 20. IMPACT OF THE STUDY AND COST ANALYSIS <ul><li>The use of a single pair of gloves in each shift has been practiced in TC 3 ICU since September 21 st 2011 </li></ul><ul><ul><li>TOTAL COST FOR GLOVES IN A MONTH </li></ul></ul><ul><ul><li>PREVIOUSLY </li></ul></ul><ul><ul><li>6gloves * 3shifts * 20 patients * 30 days </li></ul></ul><ul><ul><li>* Rs.11.98 = Rs.129384 </li></ul></ul><ul><ul><li>PRESENTLY </li></ul></ul><ul><ul><li>I glove * 3shifts * 20patients * 30 days *Rs.11.98 =Rs.21564 </li></ul></ul><ul><ul><li>DECREASE IN COST BY 83% WITHOUT INCREASE INFECTION RATES </li></ul></ul>

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