269 - Fit for all! Surgical glove fit is critical to performance and needs improvement

Description: Problem/Purpose

Surgical gloves primarily serve a safety function as a component of the barrier between patient and surgical team. This study's purpose is to understand user perceptions of surgical glove fit with respect to hand size.

Literature Review

Performance and safety evidence of surgical gloves is documented in the literature, but glove fit remains under reported. Some studies show glove fit impacts performance and safety.

Research Question/Hypothesis

Does hand size impact surgical glove fit?

Conceptual Framework

Independent Variable: hand size

Dependent Variable: surgical glove fit

Confounding Variable: gender

Methodology

An online survey on aspects of surgical gloving practice was provided to surgeons and scrubbed surgical staff in USA, UK, Germany, Sweden, and Japan from Aug-Sept 2023 using market research agency databases.

Data Analysis

Fully anonymized data both aggregated and segmented by hand size (small = glove size less than or equal to 7.0; large = glove size greater than or equal to 7.5) was processed for frequency and percentage.

Results

A total of 195 surgeons and 105 surgical staff, with 2 to 30 years experience and various specialties, were surveyed. 124 (41%) had small hands; 174 (58%) had large hands; 2 not reported. On average, females had smaller hands, representing 75% of small hand and 7% of large hand groups. All performed or assisted in greater than or equal to 5 surgeries a week. 72% used double gloves.

Respondents ranked the importance of 8 factors for choosing surgical gloves. Fit on hand was the most important factor, and 66% of small hand respondents ranked fit on hand within the top 3 most important.

The most important issue related to fit was areas of glove are too loose or too tight (19% overall ranked it first; 48% ranked it top 3; similar results for small and large hands); loose finger fit was more frequently reported by those with small hands. 32% of the small hand and 20% of the large hand group suggested more adequate / customized glove sizing as an improvement. 91% of respondents have taken action to achieve better surgical glove fit (44% changed glove brand or style, 31% decreased size, 29% increased size, 30% changed glove material, and 67% of double glovers adjusted their size combination). The small hand group was more likely to decrease their glove size (40% vs 24%); whereas the large hand group was more likely to increase their glove size (31% vs 25%).

Conclusions/Discussion

As previous studies have shown surgical glove fit can impact hand performance and safety, it is not surprising that glove fit was the most important factor when choosing a surgical glove. Despite nearly all respondents trying available options to achieve better glove fit, a large portion still reported the need for improved sizing and reported areas of their gloves being too tight or too loose. While this problem impacts the overall population of surgical glove users, those with small hands more often rate fit as their top priority, identify issues specific to loose finger areas, and more often suggest the improvement of customized sizing. This data suggests there is a significant portion of surgical staff for whom glove fit can be improved, particularly for smaller hands and females.

Perioperative Nursing Implications

Surgical glove fit is important for all operating room staff. Designs must consider differences in users, such as smaller hands and females, to support safety, performance, and surgical glove recommendations in AORN Guidelines for Sharps Safety and Sterile Technique.