The first hospital in the country to use rubber gloves during surgery is leading the quest to banish the gloves, creating a ?latex-safe? environment for patients and nurses.
?It?s the right thing to do,? says Colleen Cusick, RN, clinical products specialist at Johns Hopkins Health System in Baltimore. ?Up to 15% of healthcare workers have an allergy or sensitivity. And some patients are at higher risk for latex allergies.?
Johns Hopkins indicates its first surgeon in chief, William Stewart Halsted, developed and introduced rubber surgical gloves for use in the United States in 1894 to protect the hands of his scrub nurse from the harsh antiseptics in widespread use as disinfectants.
Latex gloves became the norm in operating rooms and, during the 1980s, on all units to protect workers from bloodborne pathogens.
But with greater exposure to the gloves? natural proteins, people began developing latex allergies, which can result in life-threatening anaphylactic reactions. Hopkins reports 6% of the general population is allergic to latex.
Hopkins established an interdisciplinary latex task force in 1997 to address the problem. Within a year, the hospital banished nonsterile latex exam gloves, replacing them with neoprene, polyisoprene or vinyl gloves.
Norrie Rabinowitz-Hirsch, RN, a latex-allergic staff nurse at Hopkins, considers the universal use of latex-free products important in decreasing exposure to the proteins, because limiting exposure may decrease the numbers of people who become sensitive.
Chances of developing the allergy increase with greater exposure to the proteins, especially if the latex comes in contact with mucous membranes or broken skin, such as hands with cracks and sores related to frequent hand washing or patients who have undergone multiple surgeries. People with certain food allergies, such as kiwis, avocados, bananas or passion fruit, also are at greater risk, so it evolved into a patient-safety issue, Cusick adds.
In the surgical suites, clinicians continued to prefer latex gloves because of their fit, flexibility and better tactile sensation. Now, with improvements in sterile neoprene and polyisoprene gloves, Hopkins has removed latex from the OR, too. The nonlatex sterile gloves cost between 30% and 50% more than latex gloves.
The hospital also has eliminated as many other medical latex products as possible from the facility, but, Cusick says, some items, such as certain catheters, have no latex-free alternatives.
?And some latex-free versions are not clinically acceptable,? Cusick says. ?[Their use] becomes a judgment call. Is this something someone needs? If the patient doesn?t have an allergy, they may do fine. Certainly, if someone has a documented latex allergy, you would not want to use them.?
Johns Hopkins also has banned latex balloons and notified all florists. When the American Red Cross conducts an on-site blood drive, the hospital requires nurses wear latex-free gloves.
?It?s a very good thing,? Rabinowitz-Hirsch says about the hospital?s latex-safe environment. ?I think more hospitals should take a stance and go latex-safe to minimize the amount of latex in the hospital.?
Debra Anscombe Wood, RN, is a freelance writer.
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