Surgery’s invasive nature with its high rate of blood exposure indicates that the risk of transferring pathogens between the surgical practitioner and the patient is quite high. During the surgical operation, the risk of pathogen transfer is increased either from the patient to the surgery operator or from the operator to the patient. These pathogens can be transferred via several routes such as blood or direct contact. The transfer of pathogens can lead to infection of surgical wounds for the patient.
This can compromise the surgery success or lengthen the time of surgery healing as well as posing some threats to the patient’s life. These pathogens can results to post-operative infections in the patients or infections of blood borne diseases during the surgical operations. They can be transferred via surgical patients and the surgical operation team body contacts especially through body fluids and blood. The surgical personnel still is likely to get some injuries from the sharp instruments used during the.
Thus there is great need to safeguard both the surgical team as well as the surgical patient from these infections as well as protect the surgical team from these injuries. I have great professional passion for surgery procedures as my objective in this is to provide both the patients and carers with clear as well as consistent advice and information regarding management and reduction of the risks of infections of surgical site.
I have also developed passion for this topic due to the problems I have observed with the surgical team getting injuries from the sharp instruments they use, thus felt the need to go ahead and find solutions for these problems and save them all. One of the main approaches used for this protection has been wearing of one pair of surgical gloves. But I have noticed over some time that, having just one pair of gloves has not proved to be effective to provide the necessary protection.
Exposure in the environment of surgical procedure is about 51% in contamination of the hands for those having on just one pair of surgical gloves as compared to 7% of the surgical operators having two pairs of the gloves. In this paper, there will be a discussion on the further reduction of these infections transfer and contamination as well as protection from sharp instruments that can be achieved through putting on more than one pair of surgical gloves or two gloves, gloves liners as well as cloth outer gloves instead of just one pair of gloves.
This is believed to reduce the contamination risks as well as provide additional barriers to the surgeon’s hands. There will also be investigation to the level of protection added by providing additional number of surgical gloves to surgical site. Through this research, I would be seeking to find if the additional surgical gloves lowers the rate of perforations to the surgical gloves innermost pairs. This pair which is just next to the skin is seen as the last barrier between the surgical team and the patient to whom the surgery is administered.
The findings are used to give the necessary advice to the surgical team and patients to reduce these risks. Research Utilization Model The Stetler Model design of research utilization was employed. This includes structure used for the conducted research as well as establish engine for altering the procedures and policies. Under this model, practitioners, nurses as well as policy makers get the summary of the research and employ it in making influencing programs and policies and decisions. The model includes preparing, validating, evaluating comparatively, making of decisions and applying the ideas.
Almost half of orthopedic procedures have scrubbed surgical operation members being at great risk of getting exposed to the bodily fluids and blood of the surgical patient. Boney procedures have been found to have relation with higher rate of failure of surgical gloves. The higher the number of instruments used in the surgical procedure the higher the rate of contamination between the surgical team and the patient. There has been identified link between the differences in the defect of the surgical gloves rate and the role played by the wearer of the gloves in the process of the surgeon.
Scrub medical personnel have been identified to have the highest risk of getting glove failure cited at 17% in most surgical operations while some surgeons have been found to be about 30%. Assistant of surgical procedures have been found to experience failure of gloves at rate of 21%. The most significant issue is that several deficiencies of the surgical gloves are not recognized until the surgical operation is over and some stains of blood are noticed on the surgeon’s hands.
Most of the injuries are most likely to take place on the hand which is seen as non dominant especially the index figure after which the thumb follows and the second figure becomes the third part where injuries are likely to happen. The finger in the body part that is most likely to be injured is the index figure of the surgeon’s left hand while the left thumb of the surgical operator is the second most common part likely to experience failure of the glove.
The reason for these happenings is that the medical practitioner performing the surgical operation usually holds the surgical instrument such as needle in the right hand where he or she is most likely to accidentally cause puncture to the opposite hand’s glove. Although there is no identified mechanism of causing injuries to the glove during the surgical procedure, there are several practices which are believed to lead to glove perforations. These include: employing instruments that are dull and retracting tissue with use of your figures (Berguer & Heller, 2004).
Loading and unloading the holder of the needle by use of hands is the other practice which can increase the rate of perforation and is seen as dangerous practice since it is to a greater extent dangerous as witnessed by the number of perforation of surgical gloves from scrub personnel . Another practice of increasing the rate of glove perforations is feeling the placement of the needle blindly with the figure’s tip. There has been a link between the failure of gloves and the health care provider experience, human fatigue, high permeability of the surgical glove as well as the surgical instrument’s complexity.
On the other hand, experience of the surgical practitioner is seen to be inversely related to the risk of failure of the gloves; the most experienced surgeons and health care providers are likely to cause the least number of glove failures. Research has indicated that there is significant decrease in performance of gloves as they keep on being used. For surgeries which takes more than two hours, the glove defects have been found to be about 56% as compared to 20% recorded by surgeries which go on for not more than one and half hours.
This implies that the rate of glove failure increases with the surgery duration. It has been indicated that the perforation of the surgical gloves’ risk rises up to 1. 115 times for each ten minutes of the surgical duration. Emergency surgical procedures have been found to have significantly higher rate of perforations for the surgical gloves than the schedules procedures which encompass scheduled duration. Surgical operations are contacted in an environment which should be extremely clean and the surgical team members should have surgical gloves which are supposed to be sterile.
These sterile gloves objective is to safeguard the surgical patient from bacteria contamination from the team carrying out the surgery or safeguard the surgery team members from contaminating bacteria from the patient’s blood and body fluids. In most surgical operations where sharp surfaces are established more so in dental surgery and orthopedic surgery, wearing of two pairs surgical gloves or double-gloving is emerging as a necessary practice.
The second pair of these gloves has been found to cover the inner ones even without having negative impact to the surgical operation. Breaks to the inner glove as well as extra-thick gloves are reduced by a glove liner between the two gloves pairs. According Department of Health (2003), out of 149,745 patients undertaking surgery operations in Britain between 1997 and 2003, 5,457 patients were found to have been infected with pathogens.
The teams carrying out the surgery operations have also been found to be at risk. For example, the incidence rate of hepatitis B as compared with the general public has been found to be three times. In case the surgical gloves become perforated then their function of safeguarding the contamination is put under compromise. Other reasons for the subsequent perforation may include injuries occurred due to sharp instruments, sutures, and fragments of borne as well as via natural tear and wear.
Some factors such as the used surgical procedures, the surgical patients risk status and the prior knowledge pertaining this, abrasions which might occur on the surgical operator’s hands as well as individual preference are some factors which influences the decision to make use of additional gloves when performing the surgery. Orthopaedic surgery, for instance, have been perceived to possess higher risks of perforation of surgical gloves as a result of the nature of the surgery that normally encompasses drilling, sawing as well as direct contact with some objects considered sharp including borne.
The Orthopaedic surgical process therefore makes surgical gloves to be much more common among the surgery team members. Also influential is the risk status of the surgical patient to whom the surgery is administered. This implies that if a certain patient is believed to have high risks for the pathogens, then there would be need for use of more than one pair of gloves as an appropriate precautionary exercises put in place (Waldrop & Doughty, 2000). Although the idea of double gloving is common in most surgery processes, the practice varies with different surgical specialties and countries.
Single pair gloves happens to be the most standard practice in most specialties but in maxillofacial and Orthopaedic surgery in countries like United States of America, most European countries as well as UK. In these countries, cloth outer gloves and glove liners are not common. In USA other surgical specialties do not employ the use of double glove. Other surgeons have not admitted to make use of double gloving because of reduced dexterity as well as sensation.
The use of surgical gloves for most surgeons apart from Orthopaedic surgery is however in raise all over. There is strong and compelling evidence regarding the wearing of two pairs or more of surgical gloves in the procedure of surgery. According to research by Tanner & Parkinson (2003), exposure in the environment of surgical procedure is about 17% in contamination of the hands for those having on just one pair of surgical gloves as compared to 7% of the surgical operators having two pairs of the gloves.
Studying the quality as well as relevance of some 18 studies regarding double-gloving from different arenas of surgery which had differences in stressors employed on use of the two pairs of surgical gloves like wire closures, bone fragments as well as number and types of instruments employed in the surgery procedure with the surgical practitioners ranging from primary surgical practitioners to scrub personnel produces results that indicates that double-gloving has increased protection barrier for the practitioners wearing them in comparison with the ones in single surgical groves.
According to the study, surgical gloves having two layers can greatly lower the number of possible breaks to the innermost glove which can give chance to cross-infection between the surgeon and the surgical patient through body fluids as well as through blood. The second pair however needs apparent lessening of skills in surgery in order to safeguard the first pair.
