• Robert H Brown, Mary A McAllister, Ann-Michele Gundlach, and Robert G Hamilton.
• Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, USA. rbrown@jhsph.edu
• Jt Comm J Qual Patient Saf. 2009 Apr 1;35(4):224-8.

BackgroundIn a follow-up to a previous article, which described the approach at The Johns Hopkins Medical Institutions to establishing a latex-safe environment, subsequent efforts to convert all the sterile gloves to nonlatex products and thereby complete the implementation of a latex-safe program are reported. Before the complete conversion to nonlatex sterile gloves, operating room use had increased to approximately one-third of our total sterile glove use during the preceding four years.New Approaches To Converting To All Nonlatex Sterile GlovesThe final stages of the conversion involved both consistent follow-through with education, training, and personnel involvement at all levels and a change in the culture of the medical facility. New and improved nonlatex glove products were coming to the market, and their costs were decreasing because of increased supply and competition.Glove TrialsFive synthetic neoprene or polyisoprene gloves-two from one manufacturer and three from the second manufacturer-were evaluated in glove trials. Overall, by manufacturer, a similar rate of acceptance among the various sterile nonlatex gloves (74.2% versus 78.1%) was found. However, to ensure that all users were satisfied, contracts were awarded to both vendors. The weekend before the conversion date of May 1, 2007, all old powdered sterile latex gloves were replaced with the new stock of nonlatex sterile gloves.The Conversion ProcessOnce financial and logistical concerns were addressed, conversion to a latex-safe environment entailed readying the organization for the change in organizational culture. Key factors were (1) general acceptance from all the chiefs of the surgical departments; (2) centralization for all purchases of medical supplies, including sterile gloves, through corporate purchasing; and (3) ongoing education and vigilance.

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