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一次性医用手套在医生诊所和医院的使用。

The Use of Single-Use Medical Gloves in Doctors' Practices and Hospitals.

作者信息

Kramer Tobias Siegfried, Brodzinski Annika, Paul Marco, Drexler Hans, Scheithauer Simone, Geffers Christine

机构信息

Institute of Hygiene and Environmental Medicine, Charité -University Medicine Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Charité-University Medicine Berlin, Germany; LADR Laboratory Group Dr Kramer & Colleagues, Geesthacht, Germany; Clean Hands Campaign,-University Medicine Berlin, Germany; Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen; Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany.

出版信息

Dtsch Arztebl Int. 2024 Oct 18;121(21):715-724. doi: 10.3238/arztebl.m2024.0159.

Abstract

BACKGROUND

Single-use medical gloves achieve their purpose only when properly used. Proper use also helps avoid undesired consequences such as excessive waste and CO2 emissions, as well as inadequate hand hygiene.

METHODS

In this selective review of the primary scientific literature, we summarize the current state of knowledge on the use of singleuse medical gloves in the health-care sector. We also provide further information from national recommendations, guidelines, and regulatory provisions.

RESULTS

Single-use medical gloves mainly serve to protect the health-care professional and are only rarely meant to promote patient safety. For reasons of occupational safety and self-protection, hand hygiene should be performed after single-use medical gloves are removed. In a study of opened glove boxes, human pathogenic bacteria were detected on around 13% of single-use medical gloves. A meta-analysis found that wearing single-use medical gloves can lower the risk of nosocomial infection (incidence rate ratio, IRR: 0.77 [0.67; 0.89]. In a randomized controlled trial, adherence for putting on single-use medical gloves without prior hand disinfection was 87%. On the other hand, where hand disinfection was expected to be performed before putting on gloves, adherence was 41%. Proper use can lower the rate of occupational skin diseases and improve adherence to hand hygiene for the five moments in which it is recommended (before and after patient contact, before aseptic procedures, after contact with potentially infectious material, and after contact with the immediate patient environment).

CONCLUSION

Limiting the use of single-use medical gloves to its proper indications promotes the safety of health-care professionals and patients and has beneficial ecological and economic effects as well.

摘要

背景

一次性医用手套只有在正确使用时才能达到其目的。正确使用还有助于避免诸如过度浪费和二氧化碳排放以及手部卫生不足等不良后果。

方法

在对主要科学文献的这项选择性综述中,我们总结了医疗保健领域中一次性医用手套使用的当前知识状况。我们还提供了来自国家建议、指南和监管规定的进一步信息。

结果

一次性医用手套主要用于保护医护人员,很少用于促进患者安全。出于职业安全和自我保护的原因,应在摘除一次性医用手套后进行手部卫生。在一项对打开的手套盒的研究中,在约13%的一次性医用手套上检测到了人类致病细菌。一项荟萃分析发现,佩戴一次性医用手套可降低医院感染风险(发病率比值,IRR:0.77 [0.67;0.89])。在一项随机对照试验中,未事先进行手部消毒而佩戴一次性医用手套的依从率为87%。另一方面,预计在戴手套前进行手部消毒时,依从率为41%。正确使用可降低职业性皮肤病的发生率,并提高在推荐的五个时刻(接触患者前后、无菌操作前、接触潜在感染性物质后以及接触患者直接环境后)的手部卫生依从性。

结论

将一次性医用手套的使用限制在适当的适应症范围内,可促进医护人员和患者的安全,并具有有益的生态和经济影响。

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