Should you ban latex or latex-allergic patients? Providers weigh in on issue

How can patients with latex allergies be taken care of in a manner that keep the patients safe and you free from liability? What products will keep your staff free from allergic reactions?

In recent years, there has been a growing movement toward having latex-free or latex-safe facilities. Because of their greater exposure to latex, health care workers are significantly more likely to be sensitized or allergic. Estimates vary, but anywhere from 3% to 22% of all health care workers are sensitized to traditional latex.

A latex-safe environment means that every effort has been made to switch out items containing latex to nonlatex products, along with removing the latex allergen sources from the environment, says Connie Jenkins, RN, BSN, MBA, director of River View Surgery Center in Lancaster, OH. A latex-free environment simply means that all latex products have been removed or eliminated," Jenkins says. She points to latex guidelines from the Association of periOperative Registered Nurses (AORN), published in the March 2004 AORN Journal, which say, "This state is considered unattainable due to the ubiquitous nature of latex products." River View went latex-free earlier this year. Other facilities also are seeking alternatives to latex products as a way to protect latex-allergic patients and employees.

Improvements in alternatives to latex have enabled Johns Hopkins to replace its sterile latex gloves, which still were in use in the hospital's operating rooms, says Robert Brown, MD, MPH, professor in the departments of environmental health sciences and anesthesiology at the Johns Hopkins School of Medicine and chair of the hospital's latex task force. In fact, Johns Hopkins has eliminated most latex. Brown estimates that 98% or 99% of the hospital's products are latex-free. Polyisoprene surgical gloves have a feel that is similar to natural rubber latex and that surgeons are more willing to accept. "It's easier than you think to be latex-safe," he says.

Norton Healthcare in Louisville, which includes a children's hospital, still uses powder-free latex surgical gloves, but otherwise seeks nonlatex products wherever possible. "I think we owe it to our employees to stay diligent on this," says Claire Rupert, RN, division director for value analysis and technology assessment at Norton. "The question we ask our vendors when they come in with a new product is, 'Does it contain latex?'"

Even Premier, a health care alliance and group purchasing organization based in Charlotte, NC, has published a catalog for its members listing products that are latex-free.

River View Surgery Center converted to a latex-safe environment because of increasing allergies among health care workers and the public. Reports of allergic reactions to latex have increased, Jenkins says. "In our 11 years of operation, we have had fewer than five employees develop latex sensitivity, but because latex allergies and sensitivity seems to be growing across the country, we decided to be proactive in eliminating latex products," she says.

Steps to going latex-safe

For River View, the first step was to develop a team to complete research and look at best practices. The team consisted of clinical support, administrative support, and materials management support.

"Our goal was to provide a latex-safe environment for River View Surgery Center which supports the pursuit of providing safe patient care," Jenkins says.

Next, the center developed a template to determine the appropriate action steps. "The first action step, after identifying what items in inventory contained latex, was to trial latex-free sterile and nonsterile gloves," Jenkins says.

They developed a list of supplies and began switching inventory when they reordered our supplies. "Therefore, we had little, if any, waste of inventory," Jenkins says. Synthetic surgical gloves were used as replacements.

"Our surgeons were on board with the conversion to becoming a latex-safe environment," she says. "They feel the importance of safety cannot be underestimated; therefore, they had no objection to switching gloves or any other supplies."

River View managers also had carpets and the duct work cleaned. "This was an effort to remove any latex allergens or residual latex dust in those areas that could potentially cause an airborne release of latex particles," Jenkins says. "We even switched our rubber bands from the brown latex brand to an orange, nonlatex rubber band."

Resource

For more information on latex, go to:

  • American College of Allergy, Asthma and Immunology. Web site (www.acaai.org/public/linkpages/latex.htm) contains guidelines for the management of latex allergies, information on safe latex use in health care facilities, review on reactions to latex, information on how to identify at-risk and high-risk patients, information on how to manage an allergic reaction, and guidelines for health care providers with latex allergies.