Understanding the Issues of Double Gloving

RESEARCH ON CHANGE

It is acknowledged that any change is difficult. Changing something about your surgical gloves is not easy. The most often-heard objection to donning double gloves has been that the wearer anticipates or perceives that donning a second pair of gloves will decrease tactile sensitivity. Quebbeman studied this and found that there was an 88% acceptance rate in the group that wore double gloves, and none of the study participants perceived any decrease in tactile sensitivity.¹⁴ Another study published by Webb and Pentlow looked at the effects of double gloving on tactile sensitivity and dexterity. The double glove testing was conducted several different ways, with the larger glove worn on the inside as well as the larger glove worn on the outside.

Surgeons were asked to tie surgical knots and complete the Dellon’s moving two-point discrimination test. The findings showed no alteration in two-point discrimination test or in the ability to tie surgical knots. Surgeons who always or usually double-glove report that a period of 1 to 120 days (2 days in most cases) is required to fully adapt to its use and surgeons who routinely double glove report decreased hand sensation much less frequently than those who do not. It appears that a period of adaptation and retraining is required for physicians to be comfortable with the double gloving technique.20 Most healthcare workers need to try several combinations of gloves before they find the right “fit” for their double gloving technique.

The consensus in the aforementioned study was that wearing the larger glove on the outside was more comfortable than wearing the larger glove on the inside.²⁰ Before the Universal Precautions was instituted in the 1980s nurses did not wear examination gloves for routine patient care. With the change to Universal Precautions it became necessary for nurses to begin to wear gloves to start IV lines. Everywhere across the country, in every hospital, could be heard the same lamenting nurse, “I will never be able to find the vein and start an IV with gloves on!” But guess what? Somehow, some way, it happened. Nurses everywhere around the country, and in every hospital, donned gloves and began starting IVs with gloves on, and began protecting themselves and their patients.

A study published in the European Journal of Cardiothoracic Surgery had this to say about wearing gloves and making a change to double gloving. “Given a comfortable size combination, it is likely that during the accommodation period, cortical retraining will occur. The somato-sensory cortex will undergo cortical remapping when challenged with new sensory stimuli. Therefore, the perception of decreased sensation, experienced by the surgeon when first using double gloves, will likely be minimized and overcome with sensory cortical remapping…the surgeon or surgical nurse who is just beginning to use double gloves should try various combinations; when a comfortable fit is found, perceived hand sensibility will likely improve with increased experience using double gloves.”¹⁰

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