[MCOH-EH] [EXTERNAL] Re: #ExtMail# Re: guidance for hand dermatitis in operating room staff

[Beining, Jennifer R.]

For my institution, the culprit was the hand sanitizing foam (Steris Brand).  About 2% of our population has a reaction to it - not enough to switch out the product.  The general instructions to staff are to use the hand cream that the company makes in addition to the hand sanitizer, and to wash hands with soap and water when it makes more sense (in addition to regular requirements).

We have a few people who need to use an alternative hand sanitizer (we use Kim-Clark Kleenex brand).  A handful of people have true allergies and are sent for allergy testing, as it is often more than one product causing the problems.

We use Esteem/Neu-Thera powder-free nitrile gloves with relatively few complaints.  The staff who have problems are those with multiple allergies.

Thank you to those who have shared.  It took us a lot of time to research alternative products, and it is nice to know which have been successful in the wider occ health community.

Jennifer Beining, MSN, JD, RN, COHN-S, NE-BC
OhioHealth Employer Services
Phone: 614-566-4917
Jennifer.Beining at OhioHealth.com<mailto:Jennifer.Beining at OhioHealth.com>
OhioHealth.com/EmployerServices

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Patrick, ReGina
Sent: Friday, June 08, 2018 10:00 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

WARNING: This email originated from outside of OhioHealth. Please validate the sender's email address before clicking on links or attachments as they may not be safe.

Debbie, can the cotton liners be used in surgery?
We also have seen an increase of hand dermatitis on our nursing units and in the surgery area.  Symptoms are worse during the winter.  Each associate completes an injury report and are given a hand dermatitis prevention handout and a skin assessment tool.   Most have symptoms resolve with use of durapro cream( Stokoderm).  There have been 3 surgical associates that required evaluation at our WIC.  2 were treated with clobetasol.  They continue to have intermittent dermatitis but it does clear after 24 hours.  The other associate has the cream but symptoms are increased with longer cases. We trialed Biogel and affinity microtouch gloves. We are still looking for a solution for him. There is a white cotton sterile glove that can be used.  May try a glove alternative from Medline first. They have quite a few sterile glove options.

ReGina Patrick RN
Associate Health and Wellness
Human Resources
Lakeland Health
1234 Napier Avenue
Saint Joseph, Michigan 49085
Tele: 269-985-4516
Fax:   269-934-8079
rpatrick at lakelandhealth.org<mailto:rpatrick at lakelandhealth.org>






From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Friday, June 08, 2018 9:47 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: Deborah A. Pruim <dpruim at lcmh.org>
Subject: Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

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There are a few companies that make them.  The cotton liners from Medline are a good choice.  (I do not own stock in Medliine! :))
Hope this helps,
Debbie

From: MCOH-EH [mailto:mcoh-eh-bounces+dpruim=lcmh.org at mylist.net] On Behalf Of Grubbs, Scott
Sent: Friday, June 08, 2018 8:38 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

She tested negative for gloves and scrub components.  She does (eventually) clear when not scrubbing for several weeks/months. She responds nicely to a shot of steroid given by her dermatologist, but cannot do that frequently.   What glove liners have you found helpful?
Thanks
Scott

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Friday, June 08, 2018 9:28 AM
To: MCOH/EH
Cc: Deborah A. Pruim
Subject: #ExtMail# Re: [MCOH-EH] guidance for hand dermatitis in operating room staff

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Is she allergic to the surgical scrub components?  Has her skin cleared up since she has not been scrubbing?  We have had nurses who were not allergic to gloves but had a high sensitivity.  There are glove liners available and they have worked well for these nurses.  Just a thought.
Deborah Pruim, RN, MSN, APN, CNS
Employee Health Services
Little Company of Mary Hospital
2800 W. 95th Street
Evergreen Park, IL  60805
Monday - Friday
6:30am-3pm
Phone:  708-229-5623
Fax:  708-229-6618
dpruim at lcmh.org<mailto:dpruim at lcmh.org>
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Grubbs, Scott
Sent: Friday, June 08, 2018 8:15 AM
To: MCOH/EH (mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>)
Subject: [MCOH-EH] guidance for hand dermatitis in operating room staff

An nurse in our institution who has scrubbed (uneventfully) for surgical procedures for several decades developed bilateral hand dermatitis last fall with significant cracking and peeling of her hands.  Allergy testing by an allergist for all the scrub/glove components was negative.  She has been using a variety of agents (and hand cleansers) prescribed by the allergist and an dermatologist and her hand will eventually clear if she doesn't scrub.  She has been prohibited from scrubbing and has been accommodated thus far, but wants to scrub.  My understanding from what I can find in the nursing literature (limited) is that she should not be handling operative tools, etc when she has open cracks in her skin, even with double gloving.  Am I correct?  Is there any guidance about how to handle this?  She is near retirement, but not ready to retire yet.  Also, if there are suggestions for specific remedies, I would be happy to pass them on to her.

Scott Grubbs, MD
WorkWell Occupational Health
Bon Secours St. Francis Hospital System
Greenville, SC
864-675-4632

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