Conserving Glove Stock

Last updated: 27 November 2020


Surgical gloves used in dental practices are a high use disposable item that must be used and managed in line with infection control requirements as outlined in the ADA guidelines for Infection Control (ICG). 

Conserving stock means using gloves exactly as required to meet infection control requirements and at the same time reducing overuse and waste. It might also mean that when certain types of gloves such as Nitrile gloves are in short supply that these are preserved for occasions when staff, practitioners and patients specifically require these.  

Wearing gloves does not replace the need for hand hygiene, hand hygiene does not replace the need for gloves 

When:  

Dental practitioners and clinical support staff must wear gloves whenever there is risk of exposure to blood, saliva or other body secretions or when hands will come in contact with mucous membranes.  

  • Gloves must be worn for all clinical procedures.  

  • Disposable gloves used in patient care must not be washed before or after use nor can they be reused. 

  • A new pair of gloves must be used for each patient and changed as soon as they are cut, torn or punctured.  

Types of gloves:  

The type of glove worn must be appropriate to the task, using the right type can reduce waste when one or more is in short supply: 

  • Non-sterile examination gloves may be worn for non-surgical general dental procedures. Gloves supplied for use in dental practice are required to conform to AS/NZS 4011.  

  • Sterile gloves must be worn when a sterile field is necessary for procedures such as oral, periodontal or endodontic surgery.(ICG Pg 7) The requirements for oral surgical procedures include using sterile gloves can be found on (ICG page 9). 

  • Heavy-duty utility, puncture-resistant gloves must be used during manual instrument cleaning, rather than disposable latex gloves. These utility gloves can be reused, but must be washed in detergent after each use, stored dry and replaced if torn, cracked, peeling or showing signs of deterioration. (ADA Guidelines for infection control Pg 8) 

  • Nitrile gloves should be retained for use only when either the staff member or a patient has an allergy to latex. 

Storage 

Boxes of gloves can become contaminated and unusable if they are not stored correctly. Keeping them away from areas in both the surgery and steri bay that might cause splash, droplet or aerosol contamination as well as away from extreme heat and water damage is important. 

  • Both opened and unopened boxes of gloves should be positioned away from possible sources of contamination, such as aerosol contamination where they will not be exposed to droplets generated by patient care or the instrument washing sink of the sterilising room. (Pg 1&7) 

  • Bulk supplies such as opened boxes of gloves, cotton rolls or gauze must be stored outside the contaminated zone and protected from contamination from splashes and aerosols. (Pg 13) 

Hand Care 

Hands must be well cared for, because intact skin is a first line defence mechanism against infection.  

  • Hand hygiene must be performed before gloving and after glove removal. 

  • Observe hand hygiene in the correct order, for example ensuring ABHR (Alcohol based hand rub) is a used immediately before gloving for the next patient. (ADA Guidelines for infection control Pg 6) 

  • Taking jewelry off to ensure you don’t puncture/rip gloves on application. All hand, wrist or nail jewellery, (e.g. rings, wrist watches and bracelets) must be removed prior to putting on gloves as their presence compromises the fit and integrity of gloves and promotes significant growth of skin microorganisms. (ADA Guidelines for infection control Pg 7) 

Thinking ahead 

  • Sometimes you can’t avoid needing to retrieve an unexpected item from the drawer mid treatment. There are options for doing this and one of them is to use over-gloves. Limiting the number of times you need to do this is important when gloves are in short supply so try to think of how to minise this before you start the procedure. 

  • If you need to dispense the additional materials then gloves must be removed and hands decontaminated with ABHR before this is done. (Pg 13)  

Excess use  

  • Don’t wear gloves when you don’t need to – For example when unloading the autoclave after a completed cycle or when setting up the room for the next patient after it’s been wiped down. 

Monitoring Stock levels 

  • Do a stock take  

Step 1: count every box of gloves in every storage area of your practice and those dispensed in each surgery. Record the stock levels. 
Step 2: Calculate the minimum quantity of gloves that you require each day at your current operating capacity. 
Step 3: Calculate the date you will likely run out of stock based on current stock levels and estimated usage (assuming you are unable to attain more stock). 
Step 4: Follow up on any stock you have on backorder and check with each company to ascertain lead times if these are in sight. 
Step 5: If you're within 5 days of being unable to practice due to insufficient stock of gloves contact ADA for support 

  • Understanding your usage 

Step 1: Consolidate stock in the practice so that only small, known amount exists in required locations such as each treatment room and the sterilisation room (steri bay) 
Step 2: Write down how boxes of gloves are in each room at the start of the day 
Step 3: Count how many are left at the end of the day and record the result. 
Step 4: Repeat this test over a few days 
Step 5: With this data at hand, objectively review scheduled appointments completed over these days to ascertain whether the glove usage was greater or less than would be reasonably expected. 
Step 6: Run regular team meetings and discuss the usage data and identify any new opportunities to conserve gloves and reduce waste. Reassess regularly to identify if newly introduced initiatives and ideas are working. 

For more information:  

https://www.ada.org.au/Dental-Professionals/Publications/Infection-Control/Guidelines-for-Infection-Control/Guidelines-for-Infection-Control-V4.aspx

List of in stock glove suppliers https://www.ada.org.au/Where-to-find-PPE 

Need support with glove shortages: [email protected] 

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