"We want all of our employees to be healthy and happy, so we decided to remove the possibility of developing glove-related latex allergies from the hospital environment so they could feel secure while delivering care to patients," said Kari Morris, BSN, CNA-BC, MHA, director of medical, surgical and critical care services at Baptist Health. "We also wanted to reduce the possibility of inadvertently exposing an allergic patient to latex."

Like many facilities, Baptist Health was aware of the risks associated with latex and was evaluating the feasibility of eliminating latex gloves. The system’s Wolfson Children’s Hospital was the first to shift away from latex and convert to a nitrile glove. To increase interest in a system-wide implementation, Morris prepared a business case for the conversion. Her team began by identifying data that suggests that the cost of treating a latex allergy can be as high as $218,000 per employee1. They also quantified potential cost savings associated with standardizing to a single, synthetic glove product.

Initially, the Medical/Surgical Value Enhancement Team, which Morris chairs, carefully evaluated both in-use and clinical studies of synthetic alternatives including vinyl and nitrile. The team quickly concluded that nitrile was a superior material to vinyl with respect to meeting Baptist Health’s clinical needs.

"As far as synthetics go, nitrile appears to provide a better barrier than vinyl and can limit our staff’s exposure to blood and body fluids in all applications," said Morris.

The team recommended a system-wide conversion to the Kimberly-Clark Sterling Nitrile Exam Glove and went to work facilitating a trial among the staff. "This was an enormous project for us," said Morris. "People generally resist change, so even though we believed nitrile was a superior barrier material, it needed to offer a latex-comparable fit and feel to be readily used by caregivers." Morris added that their Wolfson Children’s Hospital had been using Sterling Nitrile exam gloves for a few months, which helped to drive the trial.

After a one to two week trial period at each Baptist Health facility, the new gloves received a greater than 90 percent acceptance rate.

Baptist Health, Jacksonville, FL

Like a growing number of facilities, Baptist Health strives to be environmentally conscious and reprocesses as much as possible to reduce waste. Morris and her team knew that by producing less waste through glove design and standardization, they would be able to make a stronger case for conversion. Because of the unique formulation developed for Sterling Nitrile, the gloves have reduced thickness yet maintain the strength associated with nitrile. As a result, they are not only lighter, but can be packaged 150 gloves to a dispenser. Therefore, by standardizing to Sterling Nitrile, Baptist would likely be able to eliminate an estimated 44 tons of waste per year. This reduction in waste would consist of both gloves and the packaging for those gloves.

In addition to waste reduction, having 50 percent more gloves per box also frees up storage space. In Baptist’s case, they were able to gain 4,200 additional cubic feet of space per year by standardizing to Sterling Nitrile exam gloves.

"There are many important factors to weigh when considering a product transition," said Morris. "Patient and staff safety are by far the primary drivers, but decreasing the amount of waste that a facility generates while increasing storage space is an important additional benefit."

In parallel, Morris worked closely with Kimberly-Clark to quantify the monetary value of allergy prevention, product standardization, environmental stewardship, packaging design and staff efficiencies. For example, having more gloves in a standard size box makes it possible to reduce the amount of time spent restocking gloves. Based on Baptist Health’s usage, it would likely be able to restock 43,000 fewer times, saving approximately 350 hours of staff time per year.

Once the clinical, environmental and financial cases were presented to the system’s administration, conversion was approved.

Kristin McTammany, RN, and Kari Morris, BSN, CNA-BC, MHA, director of medical, surgical and critical care services, Baptist Health

Communicating key conversion drivers

Kari Morris and her Medical/Surgical Value Enhancement Team were able to ensure a smooth transition from latex to nitrile by understanding the clinical issues and by working with their vendor partner to understand the benefits to the business of delivering care. They identified key conversion drivers and communicated a rationale to hospital administration and staff members that included the following points:

• By eliminating latex gloves, caregivers and patients were not at risk of a latex-glove-related allergic reaction, and their chances of developing latex sensitivity over time were reduced.

• A better alternative to latex had been identified that appeared to provide the fit, feel, tactile sensitivity and barrier protection of latex.

• Standardizing to one non-surgical glove and minimizing the number of products in the facility would reduce confusion over selecting the right product.

• Standardization would also make it possible for the system to reduce waste and gain storage space.

• Packaging design would free up the staff to spend more time delivering care, not restocking gloves.

"Converting an entire healthcare system’s gloves is a huge undertaking," said Morris. "Because our due diligence was designed to support both clinical and business objectives, we were able to present a strong case."

Morris continued, "In the end, we believe that going latex-free was the right thing to do, and the emergence of better alternatives to latex is making that possible now. When you add the increased safety to the cost, space and waste savings that can be realized, making the case to convert was compelling."