Double Gloving: Myths Vs. Facts
Gloves act as a physical barrier against hazards.
Yet, sometimes you need extra protection to ensure this barrier doesn’t fail. In this case, you should consider double gloving.
You probably think that this is a complicated method that requires special gloves. You couldn’t be more mistaken… you can double-glove using latex, nitrile, or neoprene gloves.
Additionally, you can use sterile, non-sterile, surgical, and examination gloves.
I bet you want to know more about double gloving now, don’t you?!
Throughout this article, we will talk about the following:
- Why do we use gloves?
- What is double gloving?
- The organizations that recommend double gloving and why?
- Myths vs. facts
- Different approaches to double gloving
- When to change your gloves?
- How to don and doff them?
- Professions that use double gloving
Why do we use gloves?
Gloves are used as a protective method. They act as a barrier that protects us from chemical, biological, and physical hazards. Therefore, they are used in medicine, law enforcement, and food handling.
However, disposable gloves are prone to tearing and degradation. Thus, you need to check your glove to ensure its integrity regularly.
Additionally, some practices can help increase your protection. One of these practices is double gloving.
What is double gloving?
If you use gloves regularly, then double gloving is one of the most popular techniques you can apply. Double gloving is when you wear one pair of gloves over another.
This process offers extra protection and safety. If the outer glove has a tear or puncture, the inner glove will act as a protective barrier.
Additionally, if the outer glove is contaminated, you can change it easily without fear of the contaminant leaking inside.
Who recommends double gloving?
Double gloving is mainly performed by healthcare providers to ensure their safety. Additionally, it guarantees that the patients are protected from contaminants and cross-infections.
Therefore, it is recommended by more than seven health organizations.
The World Health Organization (WHO)
WHO recommends double gloving in surgical procedures that exceed 30 minutes. It also encourages using two gloves in countries with high rates of HCV (hepatitis C), HBV (hepatitis B), and HIV/AIDS.
The American College of Surgeons (ACS)
They state that double gloving reduces the risk of exposure substantially. Therefore, it offers more protection to the patient as well. This encourages surgeons to double-glove during procedures.
Association of Perioperative Registered Nurses
The association recommends that nurses double-glove during examinations and surgery. It also encourage other healthcare providers to double-glove in invasive procedures.
Centers for Disease Control and Prevention (CDC)
The CDC offered several recommendations in 1999 to reduce surgical site infections. They declared that the use of two pairs of gloves could reduce contact with bodily fluids and blood.
The American Academy of Orthopedic Surgeons (AAOS)
In the year 2008, the academy joined the organizations supporting double gloving. It also declared it as a method to reduce the transmission of microorganisms.
The Australian College of Operating Room Nurses (ACORN)
ACRON released a guideline for safe practice in 2014. The guide stated that its standard procedure for nurses to double-glove. Furthermore, it highlighted the importance of this procedure during invasive surgeries.
The European Center for Disease and Control (ECDC)
ECDC follows the recommendations of the WHO and the CDC. They encourage healthcare providers to double-glove before coming in contact with bodily fluids.
The International College of Surgeons (ICS)
ICS introduced the advantages of having a perforation identification system. It also encourages the practice of double gloving during surgical procedures.
Several organizations recommend double gloving to reduce cross-contamination, surgical site infection, and pathogen spread. Among these organizations are:
- The WHO
- Association of Perioperative Registered Nurses
Myths related to double gloving
Speculations surround the process of double gloving. Healthcare providers have several beliefs about the process, but some are far from the truth.
So, allow us to take you through some of the myths related to double gloving.
If you wear a glove, you are entirely safe.
This is one of the oldest misconceptions about gloves. They act as a barrier that protects you from several types of hazards.
However, these barriers can fail quickly. They can get punctured or torn. They can even leak contaminants. Therefore, if you face a dangerous hazard, you should ensure your safety by double gloving.
Thus, if the first barrier fails, the second one will keep you protected.
You can easily detect glove perforations.
Perforations are not easily detected as you might think.
Yet, many healthcare providers reported that they had perforations in their gloves that went unnoticed. They would often notice blood on their fingertips when taking their gloves off.
However, a double-gloving system can help you detect these perforations easily. Additionally, it will help reduce the risk of contamination.
You can wear your glove for the entire duration of a procedure
This is also another myth. If performing an invasive surgery, you will probably need to change your gloves more than once. ACRON recommends that healthcare providers inspect their gloves immediately after donning them.
Additionally, it recommends that healthcare providers change their gloves every 2 hours.
Sharp objects won’t necessarily puncture your glove
It is thought that during surgeries, you won’t be in danger of needlesticks or sharp objects. Another myth!
Operation rooms are full of needles and sharp objects passed around by healthcare providers. This creates a dangerous environment and puts you at risk of perforations and injury.
However, double-gloving is a way for you to minimize this risk.
Double gloving lower tactile sensitivity
Many surgeons believe that if they double-glove, this will reduce their ability to perform delicate maneuvers.
ACRON recommends that for surgeries like cataract surgery, surgeons can use a single glove system. But they still recommend double gloving for other surgical procedures.
There are several myths related to glove use and double gloving.
Double gloving is believed to be useless because gloves can never fail. It is also thought that double gloving reduces mobility and sensitivity.
Additionally, healthcare providers believe they can quickly notice a tear in their gloves. They also have low regard for the dangers of needlesticks and sharp objects in ORs.
Last but not least, they assume that when you wear gloves, you don’t have to take them off until you’re done.
Facts related to double gloving
Now that we have learned about the myths surrounding double loving, it’s time to know the truth. Allow us to offer you all the facts related to double gloving.
In this section, we won’t share opinions. We will take you through some scientific studies that prove the importance of double gloving.
Who double gloves, who doesn’t, and why
More than one study was conducted to see if surgeons, nurses, and other healthcare providers support double gloving.
In one study, nurses found that double gloving is much more effective (1). The study compared double-gloving and single-gloving systems. The results revealed that perforations take place in both settings.
However, the inner glove remains intact with double loving and ensures protection.
Another study revealed that surgical trainees are more inclined to double-glove than surgeons (2). They showed more openness toward this protective measure.
A third study stated that surgeons are reluctant to double gloving because they think it acts as an obstacle (3). They believe double gloving reduces sensitivity and has a higher cost.
Additionally, they stated that wearing two pairs of gloves leads to poor fitting and discomfort.
Surgeons, nurses, and surgical trainees use double-gloving techniques to increase safety. Double gloving has been proven to offer extra protection against perforations. However, those who don’t believe it reduces mobility and sensitivity.
Double gloving, tactile sensitivity, and mobility
Practitioners claim that double gloving reduces their ability to perform delicate operations. However, we will tell you about two studies proving this false.
The first study divided the participants into two groups (4). They were all asked to perform a specific procedure with no gloves. Then, group A operated with one glove, while group B double-gloved. Afterward, the two groups switched gloving techniques.
The study proved that performing the procedure with no gloves takes the least time. However, it also stated that double gloving doesn’t affect the time it takes to complete a process.
On the other hand, the second study examined the effect of double gloving on tactile sensitivity and dexterity (5). Seventeen surgeons participated by performing a set of tasks.
First, they performed with 1 pair of gloves. Second, with 2 pairs, wearing a large pair of gloves outside. Third, with 2 pairs, wearing the large pair on the inside.
This study revealed that double-gloving techniques don’t affect sensitivity or mobility. However, it was recommended by the practitioners to wear the larger glove on the inside for better comfort.
Double gloving doesn’t affect the surgeon’s ability to perform delicate surgeries. It doesn’t affect sensitivity, mobility, or dexterity.
The effect of double gloving on cross-contamination
Cross-contamination and cross-infection are serious dangers that are found in healthcare settings. Three studies prove that double gloving is beneficial for healthcare providers and patients.
One study observed the effect of double gloving on reducing contamination in the OR (6). Anesthesiologists were asked to perform an intubation on a dummy. The mouth of the dummy was lined with fluorescent material.
During the study, one group used a single glove system while the other used double gloving. The double-gloved group took off the outer pair of gloves as soon as they were done with the intubation.
Then, the room was inspected for fluorescent spots. It was revealed that taking off the outer pair of gloves reduced contamination by 75%. Thus, double gloving reduces contamination and the spread of infections.
Another study examined the effect of double gloving on reducing blood contamination (7). As we previously stated, perforations happen almost all the time.
However, if the outer glove is torn or punctured, the inner glove will ensure safety. Thus, a double glove system can reduce the risk of blood contamination.
The third study supported the finding of the second one (8). It proved that wearing two pairs of gloves reduces the perforations of the inner glove.
Additionally, this study recommends wearing a liner between two pairs of latex gloves. This will lower the risk of perforations to the inner gloves even more.
Double gloving reduces the spread of infections.
Once you are done with your procedure, you reduce contamination rates if you take off your outer gloves. Additionally, if your outer glove tears, your inner glove will prevent the blood from contaminating your hand.
The risk of needlesticks and double gloving
We mentioned that you are at a high risk of percutaneous injuries in an OR. A study revealed that suture needles, scalpel blades, syringes, retractors, and electrosurgical tips are responsible for 72% of percutaneous wounds.
Therefore, we researched the effect of double gloving on percutaneous injuries (9). we found that double gloving reduces the perforation rates to the inner gloves.
Double gloving can be used as a barrier to lower the risks of needle sticks.
Sterile vs. non-sterile
Now you might wonder if the pairs of gloves should be sterile or not (10). A study was conducted where two groups of surgeons were. The first group used two pairs of sterile surgical gloves.
The other group used an inner non-sterile glove and a sterile outer glove.
However, this study showed no difference in perforation rate in both groups. Therefore, you can use an inner non-sterile surgical group to reduce costs.
Whether you wear an inner sterile or non-sterile glove, it doesn’t matter. Both methods offer the same level of protection. However, non-sterile gloves are cheaper.
The importance of double gloving
The previously stated studies reveal the importance of double gloving in surgery. Additionally, they manage to eliminate any misconception regarding double gloving.
- Reduces the risk of contamination
- Protects from percutaneous injuries
- Reduces the rate of perforations of the inner glove
- Protects both healthcare providers and patients
- Is recommended by several medical organizations
Additionally, the studies proved that double gloving does not affect tactile sensitivity or mobility.
Are there different double-gloving approaches?
Using a perforation indication system is essential to know whether you are protected. Thus, double gloving can take place through more than one technique.
Disposable gloves used to be white; then, blue was introduced. Yet, recently you can find disposable gloves in any color you want.
Therefore, it seems practical to use this to our advantage. When double gloving, you are recommended to use two different colors. An inner dark hue and an outer lighter one.
Consequently, if the outer glove tears, you can easily see the inner color and spot the rip.
Using glove liners
As previously mentioned, using a glove liner when double-gloving can reduce perforations. It will also allow you to detect tears more quickly as you will be able to spot the liner.
With an intrinsic perforation identification system, some companies produce double-layered gloves.
Thus, this two-in-one glove system ensures your safety. You can easily spot perforations and tears in these gloves.
You can also double-glove using gloves with different thicknesses to guarantee safety. For instance, you can use an inner thicker glove. This is to assure that you remain safe if the outer one is perforated.
Several double-gloving techniques can ensure your protection. However, you should change the outer glove immediately whenever it is compromised.
When to change your outer gloves?
We previously explained that changing your gloves every 2 hours during surgeries is recommended. However, other reasons might require you to change your gloves. Additionally, some factors might contribute to the glove’s failure.
Reasons to change your glove: Let’s take a closer look at the scenarios where you need to change your gloves.
When you touch a non-sterile surface
You might accidentally touch a non-sterile surface. Therefore, you should immediately change your outer glove to ensure your and the patient’s safety.
Additionally, this will stop the spread of contaminations.
When you see a puncture
Tears, punctures, or cuts are the main reason to discard your outer glove. The purpose of wearing gloves is to act as a physical barrier. Perforated gloves lose their ability to fulfill their purpose.
If you are switching tasks
If you are about to examine a different patient, then you should take off your old gloves first. Otherwise, you will be spreading infections between patients.
If the glove’s color change
Sometimes the glove’s color changes. You will notice yellow or brown spots. In this situation, changing the gloves to a new pair is better.
Aside from changing your glove every 2 hours, you should change it if its integrity is compromised. This can take place when it’s contaminated, punctured, or torn.
Therefore, you should examine your glove regularly.
Factors that lead to the glove’s failure
Three main reasons can lead to the glove’s failure.
Improper sizing can cause the glove to stretch and tear. Therefore, checking the size chart carefully when ordering disposable gloves is essential.
Also, sterile surgical gloves are sold in pairs, using unique size charts.
If you work in the medical field, you are surrounded by needles and sharp objects. Therefore, perforations are bound to happen no matter how careful you are.
In contrast, if you work in a lab and handle chemicals, they can react with the glove causing its degradation. Thus, you must consider chemical resistance in this situation.
Studies also prove that the longer you wear the gloves, the higher the risk of perforation.
Therefore, you should examine your glove thoroughly and regularly. Additionally, you should comply with medical organizations’ recommendations to change your gloves every 2 hours.
Some factors contribute to the glove’s failure. These factors need to be taken into consideration during the purchasing process.
How to wear two pairs of gloves?
Donning and doffing gloves is a process that should be done with care.
Double donning of gloves
- Wash your hands with soap and water for at least 30 seconds. Then dry them thoroughly.
- Make sure your gloves are the correct size.
- Unpack the first pair of gloves.
- Grasp the turned-up cuff of one of the gloves with one hand.
- Insert the other hand inside the glove and adjust your fingers.
- With the gloved hand, grasp the turned-up cuff of the other glove.
- Insert your un-gloved hand inside the glove and adjust your fingers.
- Repeat the process with the other pair of gloves.
Doffing of the gloves
- Pinch your glove near the cuff with your other hand and pull away.
- Peel the glove from your hand (ensure it is inside out).
- Hold it in the palm of your still-gloved hand.
- Insert your fingers under the cuff of your gloved hand and peel.
- The glove will be inside out and act as a bag for the other glove.
- Repeat the process with the inner pair of gloves.
- Wash your hands thoroughly with soap and water.
Some considerations for donning and doffing
- When donning gloves in a damp environment, you can feel some unease. Therefore, consider purchasing gloves that are designed to tolerate moisture.
- If you’re donning your gloves over a gown, consider wearing a pair under your sleeve and another over it. The sleeve will be trapped between the two pairs of gloves, increasing safety and sealing the gown.
- When donning the glove, ensuring the outer surface doesn’t touch your skin.
- Don’t touch the glove’s outer surface with your hands when removing the gloves. Consider the following mantra during this process “clean touches clean, dirty touches dirty.”
Double donning and doffing are similar to regular donning and doffing. However, the process is usually repeated twice. Avoid touching your skin with contaminated gloves. And avoid touching the surface of your clean gloves with your bare hands.
Other professions where you can double glove
We mentioned that double gloving is used mainly in the medical field, specifically in a surgical setting. However, other work environments may require double gloving to increase protection.
In laboratories, chemical hazards are considered a constant threat. Therefore, the use of a double-gloving procedure increases the safety margin.
Additionally, it preserves the user’s ability to perform sensitive tasks without impacting dexterity.
Furthermore, wearing gloves made from two different materials in such environments is better. Thus, if the outer glove reacts with the chemicals you work with and degrades, you will still be protected.
In a clean room, double gloving can be used to lower the risk of cross-contamination. Non-shedding gloves are used in this particular setting.
This can be a pharmaceutical manufacturing setting. In such a work environment, several standards must be met. However, double gloving helps reduce cross-contamination in such domains as well.
Laboratories, clean rooms, and aseptic pharmaceutical manufacturing areas are other work environments that benefit from double gloving.
Tips for physicians for best practice
Here are some tips and recommendations to follow when you are double-gloving.
- We can’t seem to state this enough but check your gloves thoroughly and regularly for tears and punctures.
- It is recommended that you double-glove during all major and invasive procedures. This is a must if you expect the surgery to take a long time.
- Microorganisms are capable of penetrating outer gloves if they are torn. This fact must be taken into consideration.
- Feel free to try different combinations until you find the perfect fit.
- When the outer glove tears or punctures, change both gloves.
- Follow aseptic procedures and adhere to local protocols.
- Use a reliable double-gloving method like color coding.
- Regular inspections are required to guarantee compliance with the proposed guidelines.
Double gloving is an essential procedure in the medical field.
However, it is also advantageous in other fields. For instance, you can double-glove in labs, pharmaceutical companies, and the food industry.
Additionally, you can use several types of gloves to double-glove. However, make sure you choose glove materials that are compatible with your work environment.
Thus, avoid latex if you are allergic. Also, if you work in a lab, ensure your gloves are chemically resistant to the chemicals you use. And follow the safety procedures when you don and doff your gloves to protect yourself.
You are now fully equipped with all the information you need. Go ahead and purchase suitable gloves for yourself.