Glove performance also has an effect on safety, particularly in a surgical environment. Surgeons using plastic gloves with less-than-optimal frictional properties, for example, may be more likely to drop instruments, to slip when performing delicate procedures, or to increase their stress levels when attempting to compensate. Similarly, practitioners who cannot feel a pulse through gloves when taking blood will be more likely to remove the gloves and increase their risk of infection. A 1994 survey of health care workers11 found that a “perceived interference with technical skills” was a common obstacle to compliance with universal precautions. There is also a subjective element to the performance that must be considered, which is that practitioners’ comfort and confidence in their gloves may affect their concentration levels and therefore their ability to perform surgery over extended periods of time.
It is vital that the glove design process includes an assessment of their effect on manual performance to ensure that practitioners can operate safely and efficiently. The first step in this process is to determine the key aspects of manual performance in medical practice and where current gloves have a significant adverse effect. The second is to design tests that are useful predictors of clinical performance. It is therefore necessary to identify the tasks that are most challenging and on which gloves are thought to have the greatest impact so that the tests can be designed to simulate relevant manual skills.
To achieve this, semistructured interviews with medical practitioners were carried out. As well as gathering information on the participants’ roles, disciplines, and glove use, a series of open-ended questions were used to identify tasks believed by users to require the most dexterity and tactility, and those most affected by glove performance, as well as any other issues related to HDPE gloves that might aid the study. The interviews took place within Sheffield Teaching Hospitals NHS Foundation Trust (STH) and received ethical approval from the research ethics committees of STH and The University of Sheffield, UK.
Focus groups were considered as a means of gathering data fairly quickly and stimulating discussion. However, the limited availability, particularly of senior staff, made this a difficult approach. Furthermore, it has been shown12 that, when recruitment, transcription, and analysis are included, focus groups can be much more time-consuming than individual interviews. Although focus groups are generally accepted to produce a wider range of responses, this is not always the case and depends on the nature of the questions.12, 13 In this study, many of the questions were of a technical nature and specific to the individual’s specialty. There was also a concern that participants’ opinions on specific gloves would be influenced by those of their colleagues.
Interviews were therefore conducted on a one-to-one basis to increase flexibility and enable senior staff to participate at their own convenience, often between operations or appointments. The questions were designed to be sufficiently open-ended so that the participant was not led down one particular line of thought but also included prompts where information was not forthcoming. With a wide enough selection of participants, it was hoped that a consensus would be formed in at least some of the areas, which would enable judgments to be made on the most productive direction for future research.