Infection Control
Performing Sterile Gloving
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Safety
- Choose latex-free or synthetic gloves if the nurse or patient is allergic to latex, is at high risk for latex allergy, or has a suspected sensitivity to latex.
- Do not use gloves from a torn or wet package of sterile gloves. The gloves in such a package are considered contaminated. Signs of water stains on the package indicate previous contamination by water.
- Select the proper glove size. The gloves should not stretch so tightly over the fingers that they tear easily, but they must be tight enough to pick up objects easily. There is less chance of contamination if you wear the correct glove size.
- Interlock your fingers, and hold your hands together in front of your body and above the level of your waist while waiting to handle sterile items.
Equipment
(Roll cursor over items to see labels)
Package of properly-sized sterile gloves - latex
Package of properly-sized sterile gloves - synthetic nonlatex
PrintableDelegation
Nursing assistive personnel (NAP) may assist with skills that include the application and removal of sterile gloves. However, many procedures that require the use of sterile gloves cannot be delegated to NAP. Be sure to inform NAP of the following:
- Explain the reason for using sterile gloves for a specific procedure.
Preparation
- Consider the patient’s risk of infection, including factors such as preexisting conditions and the size or extent of the area being treated.
- Inspect your hands for cuts, hangnails, open lesions, and abrasions. In some settings, you are allowed to cover any open lesion with a sterile, impervious transparent dressing (check agency policy). In some cases, the presence of such a lesion may prevent you from participating in a procedure.
- Consider the type of procedure to be performed, and consult your agency’s policy on the use of sterile gloves.
- Examine the glove package to determine if it is intact and dry, with no water stains.
- Before applying latex gloves, assess the patient for the following risk factors:
- Previous reaction to the following items within hours of exposure: adhesive tape, a dental or other face mask, golf club grip, ostomy bag, rubber band, balloon, bandage, elastic underwear, IV tubing, rubber gloves, or condom
- Personal history of asthma, contact dermatitis, eczema, urticaria, or rhinitis
- History of food allergies, especially to avocado, bananas, peaches, chestnuts, raw potatoes, kiwi fruit, tomatoes, or papayas
- History of adverse reactions during surgery or a dental procedure
- Previous reaction to a latex product
- Select the correct size and type of gloves.
- Place the glove package near the work area.
Follow-up
- Assess the patient for signs of infection, focusing on the area being treated.
- If a patient develops an allergic reaction to latex:
- Immediately remove the source of latex.
- Bring emergency equipment to the bedside. Have an epinephrine injection ready to administer, and be prepared to initiate IV fluids and oxygen.
Documentation
- It is not necessary to record the application of gloves. Record the specific procedure performed and the patient’s response and status.
- If the patient has an allergic reaction to latex, record it on the vital sign flow sheet. Note the specific type of reaction and the patient’s response to any emergency treatment provided.
Review Questions
1. Which action would the nurse perform first when preparing to apply sterile gloves?
Perform hand hygiene.- Place the package on a stable, flat surface.
Assess the glove packaging for wetness or tears.- Open the outer packaging.
INCORRECT. The nurse performs hand hygiene after selecting the gloves and placing them on the work surface.
INCORRECT. The nurse places the package of gloves on the work surface after inspecting the integrity of the package.
CORRECT. The nurse first assesses the packaging for wetness or tears; any breach in the packaging compromises the sterility of the gloves.
INCORRECT. The nurse opens the outer packaging after inspecting the integrity of the packaging, placing the package on the work surface, and performing hand hygiene.
2. When are sterile nonlatex gloves recommended for a sterile procedure?
- When there is a possible sensitivity issue
- When the staff member prefers them
- When latex gloves are not conveniently available
- When the patient prefers them
CORRECT. The possibility of a serious allergic reaction to latex necessitates the use of nonlatex gloves when the patient or nurse is sensitive to latex.
INCORRECT. Staff preference is not a reason to select nonlatex sterile gloves.
INCORRECT. Staff should use latex gloves unless there is a sensitivity issue.
INCORRECT. Unless the patient has a known latex allergy, he or she is not usually consulted regarding the type of glove a staff member uses.
3. What is the most important step the nurse can take to minimize the risk of tearing a sterile glove when applying it to the hands?
- Using powdered sterile gloves
- Keeping the fingernails trimmed and smoothly filed
- Selecting the proper glove size
- Drying the hands thoroughly before applying the gloves
INCORRECT. Most sterile gloves are powdered. Since using unpowdered gloves is usually not an option, using powdered gloves does not reduce the risk of tearing a sterile glove.
INCORRECT. Keeping the fingernails well trimmed and smoothly filed is prudent, but it is not the most important step the nurse can take to reduce the risk of tearing a glove.
CORRECT. Improper glove size is the leading cause of glove tears.
INCORRECT. Drying the hands thoroughly before applying gloves is prudent, but it is not the most important step the nurse can take to reduce the risk of glove tears.
4. After applying sterile gloves, the patient states she is uncomfortable and would like to move to her left side. What is the best way for the nurse to keep the gloves sterile while waiting for nursing assistive personnel (NAP) to position the patient for a sterile dressing change?
- Interlocking the fingers and keeping the hands above waist level
- Keeping the arms at the sides, with elbows bent and gloved hands pointing up
- Leaving the room momentarily
- Stepping back from the bedside where NAP are working
CORRECT. Once the gloves have been applied, the fingers should be interlocked and held in front of the body above waist level.
INCORRECT. This position is not appropriate sterile technique.
INCORRECT. Leaving the room is not appropriate; the nurse will stay in the treatment area after gloving.
INCORRECT. Stepping back from the bedside and other traffic areas is prudent, since turbulent air can contaminate gloves, but it is not the most important step the nurse can take to keep gloves sterile.
5. Which protocol does not vary among institutions?
- Acceptability of wearing artificial nails in patient care areas
- Use of impervious transparent dressings to cover open lesions on nurse’s hands during sterile procedures
- Use of sterile gloves for sterile procedures
- Sterile gloves are only available in “one size fits all”
INCORRECT. Many, but not all, health care institutions prohibit artificial nails and extenders in clinical areas. Review your agency’s policy before performing a sterile procedure.
INCORRECT. In some settings, nurses are allowed to cover open lesions with a sterile, impervious, transparent dressing. In other settings, the presence of such a lesion may prevent the nurse from participating in a sterile procedure. Review your agency’s policy before performing a sterile procedure.
CORRECT. By definition, a procedure is not sterile if sterile gloves are not worn.
INCORRECT. Sterile gloves are available in various sizes, such as 6½ and 7. The availability of gloves will vary among institutions.
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