PPE dry intact skin

Do-over, ASN, RN · Jun 8, 2012

I guess I'm of the school of thought that donning gloves just to touch a patient when no body fluids or symptoms of infection are present can be alienating for the patient. Touch is such an important part of providing care and comfort that I will not put gloves on as a barrier between me and my patient if they are not indicated. If I happen upon a "surprise", it's no big deal to stop, wash my hands, and then apply appropriate PPE.

This.

blondy2061h, MSN, RN · Jun 8, 2012

I try and wear gloves when touching someone in bed just because you never know what's hiding under some covers.

sauconyrunner · Jun 8, 2012

Just a reminder that Gels and soap and water and gloves are not interchangable. Quoting the OP "But I was under the impression that I dont need gloves to touch the clean/dry/intact skin on a patient who is not on precaution... I thought thats what all the gel and handwashing was for! Am I being too careless or was the tech being a little over paranoid? Just wanted to ask here...thanks a lot!:

Even if you were to put gloves on you would STILL have to do hand hygiene before and after wearing those gloves.

But on the original question, I do think it's fine to touch a patient's skin that is not draining nasty things....I think the tech was a bit over cautious. I'll also note that we have had a few complaints from patients, "The nurse did not wear gloves when taking my Blood Pressure.." I never understand that...:uhoh21:

Anna Flaxis, BSN, RN · Jun 9, 2012

I guess what got me going was the HIV/HCV part of the OP. People with these diseases face stigma as it is, and to have caregivers, who should be educated on the transmission of these diseases, using PPE when it's not called for....well, it just makes me angry on their behalf.

That tech needs to be educated on disease transmission.

HCV is transmitted by blood to blood contact. That means, the HCV+ blood has to get into your blood. It is not fecal-oral, and it will not magically absorb through your intact skin. You can't get it from sharing a cup or a towel.

HIV is transmitted by direct blood to blood contact, as well as contact with blood and body fluids to the mucous membranes. You're not going to get it simply from touching a person with HIV.

If I were a patient with one of these diseases, I would be pretty upset if my caregivers felt the need to use PPE just to touch me.

Vinniesguy · Jun 9, 2012

I make my own judgement on whether gloves are necessary or not - if I know the patient well enough not to stick my fingers in something nasty then I don't bother otherwise I will.

If I was tending to a patient that wasn't mine I probably would stick a pair on just to be on the safe side.

But to put on a pair becuase they may have HIV - bit OTT!

celtchick68 · Jun 9, 2012

i ALWAYS put on gloves when anticipating coming into contact with blood/fluids.

While I don't glove up for every patient interaction this statement gets me every time! How many times does a patient vomit or expel some other random body fluid? You could be checking a pulse ungloved on a seemingly normal patient only to have them sit up and vomit all over you. You could be helping them ambulated for the first time and they get suddenly weak and vomit on you. Obviously one gloves up when they know there's active bleeding, weeping sores etc and when changing soiled items. When simply checking vitals you don't "anticipate" coming into fluids but it's always a possibility. It doesn't change my technique and as I said, I don't wear gloves unless actual body fluids are an issue.