The Assessment of Medical Gloves for In-Situ Applications

Medical examination gloves are used worldwide and are one of the most common personal protective equipment (PPE) used. The polymers used to develop these gloves undergo rigorous testing to ensure they meet the requirements for use. Primarily, these tests assess the barrier integrity and tensile properties. The effects of placing a membrane over the hand, however, has been shown to be detrimental to the successful performance of tasks carried out by the wearer. The extent of this reduced performance is unknown, but any reduction in tactility and/or dexterity could be disadvantageous to patient care. It could also impact PPE compliance, causing users to remove gloves for certain tasks. As such, this research introduces a range of test methodologies for donning and doffing gloves, as well as assessing how friction is modified with the introduction of contaminants that are encountered when gloves are worn. In order to effectively assess glove performance, the environments gloves encounter, which have received little attention in previous studies, should be carefully considered and replicated as closely as possible. The aim of this thesis is to investigate the effects of gloves on users when they are used in-situ Test protocols were developed to cover three key performance areas: donning and doffing, glove contamination, and dexterity. Manual performance tests were set up using readily existing dexterity and sensitivity tests (Purdue pegboard and a simulated tactile (bumps) test). To better understand donning and doffing, friction assessments were conducted to assess the tribological interactions between the skin and the inner surface of glove materials, having undergone different treatments. The friction assessments were repeated for interactions between the outer surface of glove materials and objects with textures that replicated typical hand and tool interactions, both in dry and simulated contamination conditions (water, mucus, blood and other bodily fluids). Three key stages of the donning process were identified (preparation, hand insertion and manipulation), and in all stages, moisture was found to significantly complicate the donning process, as the gloves stuck to the hands more frequently. In wet-hand conditions, polymer coated latex gloves were quicker to don and had lower friction than chlorinated gloves. In addition, nitrile gloves were manufactured specifically for this project, looking at different thicknesses and chlorination treatment strengths. Chlorinating nitrile gloves at 2000ppm appeared to be more beneficial for donning. Doffing was found to be similar regardless of the material, condition, or thickness. The gloves that produced stiffer tensile material samples were found to reduce friction and reduce the dexterity performance of the glove users. When gloves were contaminated, friction was found to be greatly reduced when compared to the dry condition. This reduction in friction was greater for latex, which decreased the gross dexterity and sensitivity of the user. Smaller reductions in friction were observed overall with nitrile, combined with an improvement in dexterity and sensitivity. A synthetic blood was also developed and validated for the tribological properties to circumvent the need for use of animal blood in future friction assessments. Knowledge of which physical properties affect which key performance area is fundamental to manufacturers. Optimising the combination of these properties (within other constraints such as cost, constituent availability, and ecological impact) will improve task performance, increasing user satisfaction, and ultimately, PPE compliance and patient safety.