Double Glove with HIV positive patients

[abbaking]

Many a times during report when being told I willcare for an HIV positive patient, my co-workers will warn me to "Double Glove" when providing routine care. To me this seem like some sort of old-fashioned thinking. These same co-workers of mine have been in MRSA isolation room with no gloves or will empty urinals with no gloves, but then to say "Double Glove" with HIV patients is like saying (to the patient) I fear you, your a disease and a statistic. It make me feel sad for my co-workers ignorance and for my patients' sense of dispair.

[Hilinenursegrl]

Many a times during report when being told I willcare for an HIV positive patient, my co-workers will warn me to "Double Glove" when providing routine care. To me this seem like some sort of old-fashioned thinking. These same co-workers of mine have been in MRSA isolation room with no gloves or will empty urinals with no gloves, but then to say "Double Glove" with HIV patients is like saying (to the patient) I fear you, your a disease and a statistic. It make me feel sad for my co-workers ignorance and for my patients' sense of dispair.

They are called universal precautions for a reason; they will be your best protection universally across the board. I don't feel there is any need to "double glove" I work in the ER with lots of HIV, Hep, and a whole host of other things and I feel more that confident that "single gloving" will keep me safe as long as I use all my other safety procautions.

[CHATSDALE]

if you have open cuts/abrasions on your hands double gloving will protect you from a incompetent glove unlikely that two gloves will have a hole in same place

your patients should not have a sense of dispair, gloving should be quickly and without fanfare

alsway use gloves when doing anything to do with bodily fluids but esp with a mrsa patient. i have never heard of not doing so

[nursejohio, ASN, RN]

Many a times during report when being told I willcare for an HIV positive patient, my co-workers will warn me to "Double Glove" when providing routine care. To me this seem like some sort of old-fashioned thinking. These same co-workers of mine have been in MRSA isolation room with no gloves or will empty urinals with no gloves, but then to say "Double Glove" with HIV patients is like saying (to the patient) I fear you, your a disease and a statistic. It make me feel sad for my co-workers ignorance and for my patients' sense of dispair.

That is so sad, or infuriating, however you'd like to think of it. Standard precautions are just that *STANDARD* because if you consistently use them, you're protecting yourself from undiagnosed HIV, along with most other bugs that may come along. No reason to mention that HIV not a casual contact illness, and that putting on 15 pairs of gloves won't protect from the needlestick injury that would be our most concerning method of exposure!!!

[Murse901, MSN, RN]

I don't understand why there is still such a huge fear in healthcare occupations over HIV patients. I'm much more scared of Hepatitis. An HIV patient can spray gallons of blood all over the place, and there's little to no danger after a few hours. With Hepatitis, a single drop of blood can stay infectious for a few weeks.

As to the OP's question, double-gloving seems ridiculous. True, if you have open cuts on your hands, it can possibly negate the consequences of a faulty glove, but we're all taught to keep a band-aid over that cut at all times while working anyway, so what's the point?

[shellsgogreen]

i don't pay attention to ignorance anymore - especially during report; i just take in the pertinant information and keep it moving.

i've learned you can't change the way people think, so i argue less and try to lead by example.

[KyPinkRN]

I don't understand why there is still such a huge fear in healthcare occupations over HIV patients. I'm much more scared of Hepatitis. An HIV patient can spray gallons of blood all over the place, and there's little to no danger after a few hours. With Hepatitis, a single drop of blood can stay infectious for a few weeks.

As to the OP's question, double-gloving seems ridiculous. True, if you have open cuts on your hands, it can possibly negate the consequences of a faulty glove, but we're all taught to keep a band-aid over that cut at all times while working anyway, so what's the point?

Band-aids over open cuts on your hands aren't exactly practical when you are washing your hands every 20 minutes or so. I actually think it encourages bacteria growth at that point. I glove consistently whenever I will have contact with the patients linens, or bodily fluid. Now during flu season I have even begun to glove when I think I will be touching surfaces that patients touch with their hands on a regular basis. Patients don't wash their hands nearly enough, and most of ours have been sniffly and snotty lately.

The following is directly from the CDC's flyer on exposure information:

HIV

 The average risk of HIV infection after a needlestick or cut

exposure to HlV-infected blood is 0.3% (i.e., three-tenths of one

percent, or about 1 in 300). Stated another way, 99.7% of

needlestick/cut exposures do not lead to infection.

 The risk after exposure of the eye, nose, or mouth to HIV-infected

blood is estimated to be, on average, 0.1% (1 in 1,000).

 The risk after exposure of non-intact skin to HlV-infected blood is

estimated to be less than 0.1%. A small amount of blood on intact skin

probably poses no risk at all. There have been no documented cases of

HIV transmission due to an exposure involving a small amount of blood

on intact skin (a few drops of blood on skin for a short period of time).

The rate for transmission of Hep B is much higher (6-30%), here is a link

http://www.cdc.gov/ncidod/dhqp/pdf/bbp/Exp_to_Blood.pdf

Check it out.

[RN1982]

To be honest, I'm more concerned about being "double gloved" when caring for a Hep C positive patient.

[AWanderingMinstral]

Many a times during report when being told I willcare for an HIV positive patient, my co-workers will warn me to "Double Glove" when providing routine care. To me this seem like some sort of old-fashioned thinking. These same co-workers of mine have been in MRSA isolation room with no gloves or will empty urinals with no gloves, but then to say "Double Glove" with HIV patients is like saying (to the patient) I fear you, your a disease and a statistic. It make me feel sad for my co-workers ignorance and for my patients' sense of dispair.

Because, of course, that second pair of gloves is going to protect you from a needle stick. What a bunch of idiots. Thank you, abbaking, for your posting. The sad reality is that A LOT of people still think like this.

[rjflyn, ASN, RN]

I personally double glove if I am going to be dealing with blood/bleeding on any pt. Thats because I have had many a glove fail in 20 yrs. Do I put on double gloves just to start an IV on an HIV pt no. I just use more care in not spilling any of that pts blood, same goes for anyone who I know who has Hep B or C. Do the pts notice, no its transparent in my practice anyway.

Rj

[woknblues]

I saw some compelling arguments for double gloving around here a few months back, but for general use, not just for HIV. I can't see how just doing it for HIV is reasonable, as there are infectious, and equally deadly diseases out there.

[wooh, BSN, RN]

The only time I double glove is if I'm going to be cleaning up a big code brown, so when my top gloves get really dirty I can pull them off real quick and keep going with the underneath set of gloves.

Double gloves aren't going to protect you from a needle stick. And if you think they are protective, wear them for EVERYONE because it's not the one you know is whatever + that will get you, it's the undiagnosed whatever that will.