Honestly: Do you wear gloves every time?

Y2KRN · Jul 4, 2001

Always!!! :)

jamistlc · Jul 4, 2001

Greetings All Nurses,

I admit it I am guilty of not always following the standard of care for the sake of time and ease of the client. I have grabbed a urinial from a patient before it spilled without gloves. Or while changing a beds linen. I always use gloves while taking a accu check, D/C'ing an IV and all other activities where there is frank blood! I also always use good hand washing tech. between patients and treatments (even on the same client). I consider myself to be pretty safe. And when I do something in a hurry I always wash my hands STAT! I have actually worked as a PRN agency nurse at institutions that were under stocked or out of supplies that are basic for good care i.e. gloves, alcohol swabs, and bedside care products. It is when I need them or want to use them and they are not on site that I most consiously am aware that I am not following a standard of care or universal precautions! :eek:

Home Health Columnist / Guide · Jul 4, 2001

Click here to read about the CDC's March 2000 national estimates of annual percutaneous injuries, using combined data from the CDC's NaSH database and the Center's EPINet network.

http://www.med.virginia.edu/medcntr/centers/epinet/estimates.html

Annual Number of Occupational Percutaneous Injuries and Mucocutaneous Exposures to Blood or Potentially Infective Biological Substances (revised 6/15/98)

The following figures were calculated based on 1996 EPINet data. We do not know to what degree new HIV treatments have affected health care worker risk of HIV infection. They have probably reduced the risk somewhat since there are now fewer AIDS patients in hospitals.

We estimated percutaneous injuries and blood and body fluid exposures in one year, based on:

30 injuries per 100 occupied hospital beds reported (from our national EPINet data for 1996)

600,000 occupied hospital beds in the U.S.

180,000 injuries in one year reported in hospitals (.3 x 600,000)

39% of incidents not reported (according to surveys conducted in 6 EPINet hospitals in 1996-1997) = 295,082 injuries occurred in hospitals

double this figure because 50% of health care workers work outside of hospital settings (total = 590,164 percutaneous injuries)

according to EPINet data for 1996, an additional 1/3 of reported exposures (total = 196,721 mucocutaneous exposures) involve skin/non-intact skin or mucous membrane contact with blood or at-risk biological substances with can also transmit HIV, HBV, HCV

Total annual percutaneous and mucocutaneous exposures to blood or at-risk biological substances in the U.S. in 1996 = 786,885

Risk of Infection Following a Single HIV, HBV, or HCV-Contaminated Needlestick or Sharp Instrument Injury

(revised 5/09/01)

HIV 0.25% - 0.4%

HBV 6% - 30%

HCV 0.4% - 1.8%

The CDC estimates that 400 new occupational HBV infections occurred in 1995 among U.S. health care workers, down from 17,000 in 1983. (Arch Intern Med 1997;157:2601-2603)(Due to Hepatitis Immunization. Karen)

Assuming that between 1% and 2% of patients are HIV-positive (and therefore that 1% to 2% of needlesticks are HIV-contaminated) between 18 to 35 new occupational HIV infections would occur from percutaneous injuries each year. Infections resulting from blood exposures to non-intact skin or mucuous membranes would add between 2 to 4 cases (based on a transmission rate of .09% for a mucous membrane exposure).

Assuming that between 2% and 10% of patients are HCV-positive (Dr. Richard Garvin, Hepatitis Branch, CDC), between 59 to 1,180 new occupational HCV infections would occur each year. Infections resulting from blood exposures to non-intact skin or mucous membranes would add between 16 to 393 cases (assuming that the transmission rate was between 0.4% and 1.8% per exposure, with lower limit from Dr. Giuseppe Ippolito, Italy, 1999).

The consequences of occupational exposure to bloodborne pathogens are not only infections. Each year, thousands of health care workers are affected by psychological trauma during months of waiting for notification of serological results. Other personal consequences can include postponement of childbearing, altering sexual practices, side effects of prophylactic drugs, infection, chronic disabilities, loss of employment, denial of worker compensation claims, liver transplant, and premature death.

YES, I always wear gloves when doing hands on care, empying emesis basins, bedpans, foley's; starting IV's and blood draws, administerring chemo, administering injections.

No, I don't wear gloves for back rubs, prefilling insulin and other syringes, passing meds, hanging IVPB using needleless systems, changing CADD cassettes etc. The risk is not in WHO you know is HIV possitive, but in those you DON't know have Hepatitis and HIV as yet to be discovered. PROTECT THYSELF AND THY FAMILY FIRST!

BL7162 · Nov 18, 2003

I'm a CNA instructor and am totally grossed out by all of the RN's and Tech's. that don't wash their hands or wear gloves when giving my students their TB Test Inj. And then, we come to the CNA's working out there that don't wear gloves or wash their hand giving patient care ie: changing attends!!! Alot of Caregivers are doing a great job, but doesn't take much to spread some deadly stuff around! I always wear gloves when it's possible to come in touch with body fluids, have some in my car too. Have come onto two wrecks and needed them! Didn't everyone wear gloves when learning? Isn't this just common sense? Frustrated in Idaho.

Long Term Care Columnist / Guide · Nov 18, 2003

I have to 'fess up here: I cut the thumb and forefinger off the glove on my dominant hand when starting IVs. I know all about the risks, but I just can't feel anything through the gloves, which at my hospital are the thick nitrile type that are GREAT for protection but fit poorly. If someone could invent a thin glove which fit like a second skin while still protecting the wearer from exposures, I'd buy stock in the company, because I start a lot of IVs and I hate taking the risks I do. But until then......well, getting the IV in swiftly, accurately and with minimal discomfort for the patient is my priority, and then I wash my hands like crazy!!

SmilingBluEyes · Nov 19, 2003

said this before:

If it's wet and it ain't yours, DON'T touch it!....

YES I always wear gloves in any situation where I might touch body fluids, BM. PERIOD. including when I start IV's.

Faby · Nov 19, 2003

I used to work in ER and ICU, there I got used to wear gloves whenever I contacted human fluids. I?m a Head Nurse of a Maternity Ward ( it has a delivery and cesarean section room, and a new born area), and I work hard so that every nurse in my unit wear gloves, and wash their hands before and after contacting patients. It is very, very hard to achieve, but I think is basic for the patient and nursing staff.

mario_ragucci · Nov 19, 2003

Originally posted by BrandyBSN
I dont do any part of patient care without gloves on. Makes my skin crawl to touch anyone without gloves.

Use Gloves! Please!

Brady - I respect you from way back, and I gain insight from everything you said in your post but the quote here. What if a patient asked you to shake their hand? If you were my PT and wanted all contact to be gloved, I would respect that and do it. Your right about everything in your post, and wearing gloves as part of following protective precautions is essential in our environment. Heh - I would feel a little funny if someone put on a glove to shake my hand, lol. The awareness points you raise are well taken by me, but, could there be a cultural awareness issue with patients who may want, or feel uncomfortable with, gloves in certain situations when no precautions are indicated :-)

meownsmile, BSN, RN · Nov 19, 2003

i have to agree with wildflower,, wearing gloves is as much about protecting the patient as it is about protecting ourselves. Who knows what creepy crawly things we carry patient to patient off the door handles, faucet handles,, etc.

Erin RN · Nov 19, 2003

I always wore gloves when there was any sort of exposure possible except I have to be honest like a previous poster..I have been guilty of tearing the fingertip of the index finger off when I am having problems with an ABG stick..Smart?? No!! But I have done it..:) Erin

live4today, RN · Nov 19, 2003

Originally posted by BeachNurse
Taking a little poll here. I am work in I.D. and one of our co-workers was recently hospitalized. She said not ONE of the people who drew blood from her, etc. wore gloves.

A few weeks ago while visiting a friend's mother in the hospital, and after the nurses made numerous attempts to restart the patient's IV site, they had to call the doc. I said to myself, there is no way he is going to get an IV in because I have YET to see a doc place an IV successfully with the adult population ON MY WATCH anyway. :chuckle

Sure enough, the doc makes two attempts to restart the patient's IV site.......BOTH TIMES while wearing NO GLOVES! :nono: (he never got the iv in either) :rolleyes:

That doc had blood all over his hands, fingers, nailbeds. He rinsed his hands in the sink, and left the room. :eek:

live4today, RN · Nov 19, 2003

sorry for the double posts...had to edit one.