When push comes to gloves: Medline’s SmartBox™ design passes test with experts

When push comes to gloves: Medline's SmartBox™ design passes test with experts

Publication in Journal of Hospital Infection has reinforced company study showing packaging mechanism helps to reduce contamination risk, glove waste

An average reduction of 38% in the amount of exam gloves wasted per box when compared with a standard glove box? In-box contamination reduced by an average of 44%?

Those are numbers to be taken seriously - especially when a leading journal on hospital-acquired infections and prevention is amplifying them.

This winter, one of Medline's signature product innovations is getting a new wave of attention after the Journal of Hospital Infection, the official journal of the Healthcare Infection Society, published the manuscript of Medline's 2024 study on the effects of its SmartBox™ design for exam glove boxes.

Introduced in the summer of 2023 with the SensiCare Powder-Free Nitrile Exam Gloves, Medline's most popular variety, SmartBox "pushes" the layered glove stack in the box toward the opening with a simple, springless, X-shaped insert made of flexible plastic.

"The mechanism has a slight rebound when you push on it, so it's constantly keeping the tension in the box," explained Linda Dinh (right), marketing manager, exam gloves. "Because the X slowly returns to its default shape and applies pressure as gloves are removed, a clinician can usually pull a single glove at a time instead of unintentionally pulling several. There's generally no need to put a hand inside the box to dig out gloves. I think of it like a cooler at a grocery store, where you pull out a can of soda and the next one automatically gets pushed to the front."

Medline's internal testing found that SmartBox reduced glove waste by an average of 38% per box and that the contamination risk from fingers entering the box plunged an average of 44% compared with a standard box, reinforcing the impact SmartBox can have on both cost and safety. Those numbers anchored the formal manuscript, which a panel of more than a dozen physicians with the Journal of Hospital Infection peer-reviewed extensively last year before selecting it for publication in the August 2025 issue.

As Medline prepares to use this validation to introduce more customers to SmartBox in 2026, here are four more things you might not have known about this innovation:

1. At first, it was about addressing waste. But then it became more.

"Glove waste had been a pretty well-established problem in the field for many years," said Paige Wexler, R&D manager for Medline's quality team and a member of a cross-functional group that began developing SmartBox in 2018. "It was something we wanted to solve for our customers but just hadn't found the right solution for yet."

As many as 80 gloves in a "normal" box of 250 - nearly a third - are typically wasted, added Greg Gomez, principal scientist, clinical research.

"That's no surprise when you consider the number of people going in and out of room and the number of times they're reaching in there and grabbing two, three, four gloves at a time, maybe five," he said. "It doesn't take very long to get to 80 wasted."

Cardboard insert designs and rubber bands were considered, as well as other enhancements beyond the SmartGuard® film already in place on Medline glove boxes to help keep gloves in the box.

As designers moved toward the eventual SmartBox concept, they recognized they were addressing a larger issue than just wasted gloves and money: Excess glove pulls and hands inside the box were potential infection risks.

"If you mean to take two gloves and you accidentally grab three - well, now you've touched that third one," Wexler said. "Or if a third falls to the floor and is picked up - well, now it's been on the floor."

And then?

"You want to think it's going into the trash," Gomez said. "But it doesn't always go in the trash because there are plenty of clinicians thinking it would be a waste to throw it away. Someone might stick a now-contaminated glove back in the box or shove it in a pocket and carry it from room to room to use later. And those are situations that make infection-prevention folks pull their hair out."

2. Fingerpaint was part of the testing process.

To simulate the spread of microbes, many researchers use Glo Germ, a substance that's designed to be invisible until it "glows" under fluorescent lights. Gomez and his team wanted a more striking visual in real time. Kids' fingerpaint was the answer.

"We kept wetting people's hands with paint after a few glove pulls and had them continue," Gomez said. "Not only could we see the contamination building up around the box on the outside, but also on the inside and on gloves that were still within the box.

"And that's a meaningful thing - it really is. Infection preventionists in a hospital setting are always going to be concerned with cross-contamination, and glove boxes are a perfect example of where you might find contamination that can get spread from one place to another."

3. There are opportunities to go further.

As SmartBox gains popularity, the team at Medline is looking into potentially expanding it beyond the SensiCare line.

"At the end of the day, what's really cool is that SmartBox is such a simple design," Wexler said. "We all can picture that glove box where the last 50 gloves are all stuck together in a ball and you have no hope of getting just two without touching more. This is an effective solution to the problem. We want to be that solution provider for our customers so they can focus on what matters - their patients."

To learn more about SmartBox or request a sample box, visit the SmartBox page at Medline.com.