Glove Use Among Nurses
Demonstration Psychology 241
Presentation
Beverly Chew
Fort Lewis College
Glove Use Among Nurses
• Data and Story from DASL
• Reference: Friedland, L., Joffe, M., Moore,
D., et al. (1992). Effect of educational
program on compliance with glove use in a
pediatric emergency department. American
Journal of Diseases of Childhood, 146,
1355-1358.
Glove Use Among Nurses
Research Question
Does an educational program on the
importance of using gloves improve glove
use in vascular access procedures in an
inner-city pediatric hospital emergency
department?
Background
• 23 participants from ER nursing staff
observed covertly during vascular access
procedures
• Observations made at baseline, and one,
two, & five months after educational
program delivered
• Number of times gloves worn was recorded
Data Analysis:
Data Entry
• Data entered into SPSS &
Transformed
• Variables:
–
–
–
–
–
–
–
ID
Period (1, 2, 3, 4)
# Observations
# Times Gloves Worn
Years of Experience
Use ratio (worn/observed)
Experience Level (1,2)
Data Analysis:
Data Coding & Exploration
• Variable Labels, Values, LOM set
• Explore command used to create descriptive statistics &
graphs for each time period
– Histograms, Central tendency & variation measures
– Box Plots and Error Bar Graphs
Data Analysis:
Histograms: Use Ratio by Period
For PERIOD= Before
For PERIOD= One month
12
20
10
8
6
10
2
Std. Dev = .40
Mean = .26
N = 16.00
0
.05
.15
.25
.35
.45
.55
.65
.75
.85
Frequency
Frequency
4
Std. Dev = .14
Mean = .93
N = 19.00
0
.95
.05
USERATIO
.15
.25
.35
.45
.55
.65
.75
.85
.95
USERATIO
For PERIOD= Two months
For PERIOD= Five months
12
8
10
6
8
6
4
2
Std. Dev = .15
Mean = .91
N = 15.00
0
.05
.15
.25
USERATIO
.35
.45
.55
.65
.75
.85
.95
Frequency
Frequency
4
2
Std. Dev = .42
Mean = .67
N = 13.00
0
.05
.15
.25
USERATIO
.35
.45
.55
.65
.75
.85
.95
Data Analysis:
Descriptives
Before
1 Month 2 Months 5 Months
Min
0.00
0.50
0.50
0.00
Max
1.00
1.00
1.00
1.00
Median
0.00
1.00
1.00
0.93
IQR
0.50
0.14
0.13
0.75
Mean
0.26
0.93
0.91
0.67
SD
0.40
0.14
0.15
0.42
Skew
1.23
-2.03
-1.86
-0.96
Kurtosis
-0.14
3.64
2.79
-0.96
16
19
15
13
N
Data Analysis
Side-by-Side Box Plots
(Heavy line is Median, Box is middle 50%)
Median / Mean
Use Ratio (Worn / Observed)
Before:
0.0 / 0.3
1 Month: 1.0 / 0.9
2 Months: 1.0 / 0.9
5 Months: 0.9 / 0.7
Box Plot of Use Ratio by Period
1.2
1.0
.8
42
34
23
74
31
.6
.4
.2
0.0
-.2
N=
16
19
15
13
Before
One month
Tw o months
Five months
Observation Period
Data Analysis
Error Bar Graph: Mean Use Ratio by Period
Mean Glove Use by Time Period
(Proportion of times gloves worn)
1.2
Use Ratio +/- 2 SE
1.0
.8
.6
.4
.2
0.0
-.2
N=
16
19
15
13
Before
One month
Tw o months
Five months
Time Period
Program Effectiveness
• Overall mean rate of glove use across all
observations was 74%
• At baseline, mean use was only 26%, however
after training, use increased to above 90% (93% at
1 month; 91% at 2 months)
• Glove use had dropped to 67% five months after
training
• While effective in the short term, it is worrisome
that glove use began to drop again – Why?
Adjustment for Nurse Experience
Mean Glove Use
• Does amount of
nurse’s experience
influence program
effectiveness?
• Experience coded as:
– 0-3 years Inexperienced
– 3 or more years Experienced
Effect of Experience on Glove Use
1.2
1.0
.8
.6
.4
Experience Code
.2
Inexperienced
0.0
Before
Experienced
One month
Tw o months
Five months
Observation Period
More experienced nurses are LESS likely
to maintain long term gains (p = 0.02 )
Conclusions
• The educational program was successful in the
short term: nurses’ glove use increased from 26%
to 93%
• This improvement was seen in all nurses; but, by
five months, experienced nurses’ use had dropped
to 53% while inexperienced nurses’ use
maintained at 93%
• The program needs revision to address long term
compliance by all nurses
Future Directions
• Add interview/qualitative data to quantitative measures
(why does glove use stop?; who persists longest? …)
• Improve data collection so all nurses are observed equally
frequently and during all periods; extend length of program
observation (e.g. 6, 12, 18, 24 months)
• Expand study to other medical settings & procedures
• Work with nurse training programs to institute glove use as
a habit right from the start
• Find ways to change the culture (like efforts to make use of
bike helmets and seatbelts a universal custom)