# Gloving

## Overview

Infection Prevention and Control (IPC) during procedures includes the safe management of ‘sharps’, encompasses high-level measures such as health facility design and management, protocol-based measures such as adherence to national and facility level guidelines, and individual actions by each health care provider and ancillary staff member. The health care provider is encouraged to familiarise themselves with their facility’s specific IPC protocols and reporting systems, which is outside the scope of this module.

All clinical procedures pursue the IPC goal of asepsis. The traditional hierarchy of sterile, aseptic, and clean is outdated, poorly-defined and misleading, and is no longer recommended. This module describes the difference between sterile (surgeon’s) and non-sterile (examination) gloves, and how to glove and unglove safely. Gloving for theatre is described in Scrubbing and Gowning.

## Sterile gloves

Sterile gloves are supplied in a sterilised packet with an expiry date, and are free of any micro-organisms. They usually come in sizes 5.0 to 9.0 — your size is roughly the measurement around the palm of your hand above your thumb, expressed in inches. It is safer to use two pairs of gloves (double-gloving) in surgery, but this is not a requirement, and it uses up gloves quickly. See here for when to use sterile gloves.

## Non-sterile gloves

Non-sterile gloves are supplied in boxes (sized small, medium or large) and are clean but not sterilised. When donning, try to touch only the cuffs for cleanliness. Doffing works the same way as for sterile gloves. Use non-sterile gloves for contact precautions and procedures where ANTT can safely be practiced.

## Donning sterile gloves

1. Roll up your sleeves and remove watches & jewellery on the hands and wrists. Perform hand hygiene.

2. Select gloves of your size, most commonly 6.0 for women and 7.0 for men. Check that the package is not expired, not torn or wet.

3. Put the packet on a clean, dry surface and peel it open from the top. Take out the inner packet and throw away the outer packet.

4. Open the inner packet like a book. Unfold the top and bottom folds. Unfold the packet outward once more to reveal the gloves. Do not touch the gloves. Notice that the bottoms of the gloves are turned up, so the inside shows outward.

5. Use your non-dominant hand to pick up the glove for your dominant hand by the folded edge of the cuff. Slip your dominant hand into the glove and pull to fit.

6. Use your gloved hand to pick up the other glove by slipping your fingers into the gap between the cuff and the palm of the glove. Slip your non-dominant hand into the glove and pull to fit.

7. Unfold the cuffs: For each glove, insert the fingers of your other hand into the gap between cuff and palm and flip it right way around up the wrist.

8. Grasp the packet by its sterile, untouched inside surface to dispose of it.

9. To prevent accidental contamination, keep your hands above waist level, away from your clothes, and interlocked.

## Doffing sterile/non-sterile gloves

1. Grasp the palm or outside of the cuff of one glove and gently pull your hand out so that the glove turns inside out. Hold it in your other gloved hand.

2. Put the fingers of your ungloved hand inside the cuff of the gloved hand and pull down to take it off and turn it inside-out. Both gloves should now be in a ball.

3. Dispose of gloves in medical waste. Perform hand hygiene.

## Using gloves safely

1. Always wash hands before donning, and after doffing gloves.

2. Change gloves if they tear.

3. Never use one pair of gloves for more than one patient.

4. Never wash or sanitise and reuse gloves.

5. Change gloves when moving from a patient’s contaminated areas such as the perineum, to a clean area such as the face.

6. Gloves do not protect you against needlestick injuries. Always adhere to safe sharps management.

## References

1. Doyle GR & McCutcheon JA. Clinical Procedures for Safer Patient Care. BCcampus. 2015.

2. Mischke C, Verbeek JH, Saarto A, Lavoie MC, Pahwa M, Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database Syst Rev. 3. 2014. doi:10.1002/14651858.CD009573.pub2

3. U.S Food & Drug Administration. Medical Gloves. 2020. Available at: ​​https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/medical-gloves.