While it may seem silly to some, I believe I'd find myself more comfortable inserting a urinary catheter if I was able to ensure the sterility of my hands. The entire technique of open-gloving for sterile procedures always seemed shifty to me, because it ultimately leaves you with very little sterile length on the hands given that it's extremely difficult for even experienced nurses to completely prevent the outer edges of the cuffs from touching the bare arms (whether it be due to rolling, etc, or whatever)
With sleeves, you'd have a much wider range of movement with your hands, and you would also be CERTAIN that the entire area around your hands is sterile, since the gloves would stay in contact with the sterile sleeves even if they rolled nonstop, since the outer cuffs of the gloves are sterile until you actually touch them with bare hands (regardless of what they are "considered"). If you use the sleeves correctly, there's a lot of wiggle room in the cuffs without contaminating anything.
If it could be demonstrated at least that sterile sleeves decrease infections related to catheter insertion.... wouldn't their use be justified?
IF the use of sterile sleeves could be definitely shown to decrease CAUTIs, then, yes, their use is justified. However, I don't think there is anything to suggest that sleeves are going to be better than just gloves if strict sterile technique is followed.
1st rule of foleys/any sterile procedure GET GLOVES THAT FIT!!!! Those puny little ones that come in kits do not fit my hands and make it impossible. I think they are what a 6.0/6.5 in there? When you wear 8.0 its too small.
I get the surgical gloves, the ones in the kits don't fit me either.
While I have not done research on the topic, my hunch is that limiting the use and length of use of foleys would be more beneficial than using sterile sleeves. Plus, if one can't put the gloves on properly, why wouldn't the sleeves be an issue as well?
I get the surgical gloves the ones in the kits don't fit me either. While I have not done research on the topic, my hunch is that limiting the use and length of use of foleys would be more beneficial than using sterile sleeves. Plus, if one can't put the gloves on properly, why wouldn't the sleeves be an issue as well?[/quote']
if one can't put the gloves on properly, why wouldn't the sleeves be an issue as well?
I think there's a fundamental misunderstanding about what I'm asking. I'm not saying "putting on sterile gloves is hard". I'm saying "using sleeves ensures sterility better than gloves, because if you're handling them with sterile sleeves, you can ensure that not even the inner cuffs become contaminated, that way no matter how much the gloves roll (something that's almost impossible to prevent 100%, I don't care what anyone else), be it a millimeter or 2 inches, you're still at least sterile up to your elbows.
I think there's a fundamental misunderstanding about what I'm asking. I'm not saying "putting on sterile gloves is hard". I'm saying "using sleeves ensures sterility better than gloves, because if you're handling them with sterile sleeves, you can ensure that not even the inner cuffs become contaminated, that way no matter how much the gloves roll (something that's almost impossible to prevent 100%, I don't care what anyone else), be it a millimeter or 2 inches, you're still at least sterile up to your elbows.
Sterile sleeves are not expensive.
I can't think of a single item my department orders that would be considered "not expensive". Maybe the saltines in the pantry.
If elbows/arms are needed when placing a foley (and I am not saying that doesn't happen), then what one needs is additional staff in the room to help.
Another hunch is that it isn't putting on the gloves that may cause an issue with sterility, it is after when one starts touching/doing things. Again, sleeves will not help with that.
Don't you think it would be basically impossible to put on a sterile glove AND a sterile set of "sleeves" all while at the bedside? That would be cumbersome.
I think that is a matter of perspective. Medical equipment tends to be expensive. Especially sterile "stuff." As I said earlier, if it can be shown that the is a true decrease in CAUTIs with sleeve use, then, use the cost is justified. However, my hospital and my NM are not going to approve their purchase/use just because something thinks it might be more convenient. Back it up with EBP.
I never used my forearms and elbows in Foley insertion or wound care. I knew (and practiced, as a student in lab) enough not to let my sterile supplies go flying around out of control-- that's Sterile Field 101 in my book, and probably in yours
Cost. If somehow I was charge nurse on your floor and saw that you procured a sterile gown for a freaking foley catheter insert I would be very angry. Nurses get laid off because of cost saving measures all of the time and you using costly sterile gowns for no reason is absurd.
psu_213, BSN, RN
3,878 Posts
IF the use of sterile sleeves could be definitely shown to decrease CAUTIs, then, yes, their use is justified. However, I don't think there is anything to suggest that sleeves are going to be better than just gloves if strict sterile technique is followed.