Who wears gloves when starting an IV? - page 3

I've been a nurse for 29 years and have a really hard time starting IV's with gloves on since I learned to do it without gloves and have been doing it for years without gloves. I try my best to wear... Read More

  1. by   dknunges
    You should always where gloves when starting IV's ( and doing any invasive procedure!). When I learned to start IV's over 23 years ago I did not use gloves, and usually couldn't obtain them unless I was performing a sterile procedure. As difficult as it was I learned to start them with gloves on and index finger of glove intact. What helped me was I wore the smallest gloves possible which did make it a little easier to adjust. I do locate vein, prep site and get everything ready then put on gloves just prior to sticking.
    In regards to tearing tape. Based on INS standard 49 only sterile tape/secure strip should go under the occulsive dressing. I no longer put it on bedrail, but tear my strips and place on the inside top of IV start pack. I can then adhere to best practice by placing sterile tape under TSM dressing.
    Just my two cents
    Donna
  2. by   Lenny
    Quote from dknunges
    You should always where gloves when starting IV's ( and doing any invasive procedure!). When I learned to start IV's over 23 years ago I did not use gloves, and usually couldn't obtain them unless I was performing a sterile procedure. As difficult as it was I learned to start them with gloves on and index finger of glove intact. What helped me was I wore the smallest gloves possible which did make it a little easier to adjust. I do locate vein, prep site and get everything ready then put on gloves just prior to sticking.
    In regards to tearing tape. Based on INS standard 49 only sterile tape/secure strip should go under the occulsive dressing. I no longer put it on bedrail, but tear my strips and place on the inside top of IV start pack. I can then adhere to best practice by placing sterile tape under TSM dressing.
    Just my two cents
    Donna
    I've read a lot of the replies for rnmi, the new grad who has trouble handling tape while wearing gloves. I'd have to agree with the overwhelming majority of that advice. Wear small gloves, they not only increase the sensitivity in your fingertips, they make it easier to handle things(including tape) if you have to do it with gloves on since there is no excess slack and they form more completely around the true shape of your hand. I also do as much prep work as possible before actually putting on gloves and doing the stick, and for me at my hospital that includes tearing the tape. The only other thing I would encourage you to do is to check your hospital policy concerning IV therapy and then adhere to it the same way you adhere to wearing gloves even though your preceptor doesn't. Kudos for you, and shame on your preceptor for demonstrating poor practice habits in front of you. Donna(dknunges) had some good tips, and it sounds like she maintains the sterility of her tape, but at my facility it's completely different. We don't place tape or occlusive dressings over IV insertion sites, so the sterility of the tape isn't an issue for us. We use a clear dressing called 'Opsite'. You can see through it, and it's sterile on the side that goes against the insertion site. It has a protective backing and a non-sterile border strip that can be safely handled with clean gloves. I personally only remove the backing when I'm actually ready to apply the dressing to the site. We only use tape to anchor, secure, or reinforce tubing and dressings already in place, so clean is allright as opposed to sterile. As you can see, policies vary widely depending on your state and facility. Check out your facilities policy. Personally, I wouldn't take the word of your preceptor by the way: If she'll violate univeral precautions then she/he probably doesn't care about the hospital IV therapy policy either. Keep up the good work rnmi, and hope this helps. Dave.
  3. by   terryalbright
    Quote from DutchgirlRN
    I've been a nurse for 29 years and have a really hard time starting IV's with gloves on since I learned to do it without gloves and have been doing it for years without gloves. I try my best to wear gloves everytime but sometimes I will cut the top the finger off of the glove on my left index finger so I can still feel and then pull it up over my finger once I get a flashback. Sometimes I have an IV in before I realize that I didn't put gloves on. Old habits die hard. I was wondering if some of you older nurses have this same issue or if you younger nurses have trouble starting IV's with gloves on or are you just used to it since that's the way you learned?
    I wear gloves if my skin is really dry, if the pt. is on precautions, (yes, we still gown, glove and mask for MRSA although most of us consider it a waste of time and equipment), or if I have any (even minor) superficial cracks. The way I see it, a glove won't protect me from a needlestick and I am one who was trained without gloves. If I wear a glove I make sure it fits snugly.
  4. by   bobnurse
    Quote from Lenny
    I always tear the tape off before I even start the IV. You can even tape it to the bedside rail if you want for easy access. Then assess and choose a vein. Then I don gloves and do the deed. Good luck!
    Just remember, no tape under the opsite.
  5. by   subee
    Quote from aileenve
    You better believe I wear gloves when starting IV's where I work!
    I've been working in anesthesia a long time and I know I'm "breaking the law" in my state but a rarely wear gloves to start an IV, with the exception of inmates. I don't like people snapping that latex when they draw blood on me and I only have about 10 minutes to establish any kind of relationship with my patients. I actually like to touch them skin to skin. With firm pressure on the top of the catheter there's rarely any bleeding involved.
    A-lines are a different story. I wash my hands religiously after each IV and always let the patient see me drying my hands so they know I've washed. Besides, in the OR after your gloves are on for an induction, you touch the knobs on the machine and everything else so the sputal veneer is pretty thick and you're only fooling yourself if you think gloves are going to protect you. Wash, wash, wash.
  6. by   live4today
    I don those gloves for EVERYTHING! I enter the patient's room, and automatically don the gloves...never know what will come out of the mouth of a patient, a vein of a patient, or the "other end" of a patient while assessing them, or simply changing an IV bag. I've had some very UNEXPECTED incidents occur, and am always glad I donned those gloves! :chuckle

    Nurses...................DON THOSE GLOVES!!! Better safe than sorry!
  7. by   HillaryC
    Quote from nat829
    My question is: Is it possible for me to develop an infection from the nurse not using gloves? As a patient, shouldn't I be able to request that my nurse wear gloves while starting/stopping my IV? Should I contact the office that she works for to let them know about this? Any info you could give me would really be appreactied. Thank you!
    It's true that regular gloves (we refer to them as "clean", as opposed to "sterile") won't protect you against infection -- they're really about protecting the health care provider from exposure to bodily fluids/substances. To prevent infection, nothing should touch your skin around where the needle/IV is going to go in after your skin is prepped (including clean gloves). The only exception is when health care providers wear sterile gloves (for example, in surgery). These specially prepared gloves have nothing dirty on them, and won't contaminate the site. However, starting a routine IV does not call for wearing sterile gloves.

    Regarding handwashing, it's true that some hand preps clean hands better than regular soap and water (and health care providers are more likely to use them routinely). At my hospital, we use a chlorhexidine hand "wash" (lotion) called Avagard. The ID people at the hospital say it cleans hands better than soap and water, and it's much easier to comply with. It's true that the nurse that's starting your IV should have clean hands (I don't know what the data say about Purell) -- and to protect herself, she should be wearing gloves. The bottom line is, to protect you against infection, after your skin is cleaned (ideally with chlorhexidine), nothing (hands or regular gloves) should be touching the IV insertion site. When your IV is taken out, sterile gauze should be put over the site (and again, the nurse is supposed to wear gloves to protect herself).

    Hope this helps.
  8. by   bobnurse
    Quote from subee
    I've been working in anesthesia a long time and I know I'm "breaking the law" in my state but a rarely wear gloves to start an IV,
    Its saddening to see that you knowingly break the rules and endanger your patients by not wearing gloves. Many healthcare professionals do not wear gloves due to a lack of education, but you are well educated and know the risks and continue to perform a task while endangering your patient. Doing so puts your patients and yourself at risk.

    Lets pretend that your post makes the paper..."john doe," CRNA, performs venipuncture without gloves. Anyone that had a bloodborne infection after surgery, please call 1800-xxx-xxxx. It would make the front page. Your crazy for posting such.

    You should always wear gloves, Period!
  9. by   bobnurse
    It's true that regular gloves (we refer to them as "clean", as opposed to "sterile") won't protect you against infection
    They will protect the healthcare provider and patient if utilized correctly. The provider should not touch the prepped site with their "clean" gloves. Once the skin is prepped, it should not be touched by anthing except for the opsite covering it, and its sterile.
    -- they're really about protecting the health care provider from exposure to bodily fluids/substances.
    Its also to protect the patient from the contaminates on the nurses hands or in thier nails.
    Regarding handwashing, it's true that some hand preps clean hands better than regular soap and water (and health care providers are more likely to use them routinely).
    Yes and no.......Soap and water with friction continues to be the best method for removing pathogens from the hands. Many use alcohol gels, which are good, but they dont kill everything.....Like C-diff for example....

    When your IV is taken out, sterile gauze should be put over the site (and again, the nurse is supposed to wear gloves to protect herself). Hope this helps.
    New studies show to cover the site with opsite to prevent delayed onset air embolism, especially with central lines.
  10. by   ZZTopRN
    and that will make a believer out of you!!

    Quote from aileenve
    You better believe I wear gloves when starting IV's where I work!
  11. by   Marie_LPN, RN
    you're only fooling yourself if you think gloves are going to protect you.
    That's a poor excuse not to wear them.
  12. by   TiffyRN
    Ok, not an IV therapy nurse here, just a regular ole RN (working NICU). I started Nursing school a few months after gloves became mandatory so I was fortunate to learn that way. Of course I still see nurses today not wearing gloves. I see it way more now than I did in the adult world. Though I think we have it safer due to the fact that none of our infants are "engaging in high risk behaviours" they did just emerge from and share circulation with a mom who might not have been as low risk. We are lucky that the majority of the moms had prenatal testing for all the major diseases but not all have prenatal care and not all diseases are tested for and not all tests are fool-proof!! Besides the whole OSHA thing. . .

    The "nice" thing about starting IV's on the NICU kids is that for the most part they don't have palpable veins, it's a visual thing all the way. I have gleefully rejoiced the few times I went to start on IV on an infant that had a palpable vein. But nurses in the NICU still go gloveless, because that's the way they learned and they feel like the infants are 100% safe (except the known Hep B/C, HIV, whatever). I don't get it. . .
  13. by   bobnurse
    Quote from TiffyRN
    Ok, not an IV therapy nurse here, just a regular ole RN (working NICU). I started Nursing school a few months after gloves became mandatory so I was fortunate to learn that way. Of course I still see nurses today not wearing gloves. I see it way more now than I did in the adult world. Though I think we have it safer due to the fact that none of our infants are "engaging in high risk behaviours" they did just emerge from and share circulation with a mom who might not have been as low risk. We are lucky that the majority of the moms had prenatal testing for all the major diseases but not all have prenatal care and not all diseases are tested for and not all tests are fool-proof!! Besides the whole OSHA thing. . .

    The "nice" thing about starting IV's on the NICU kids is that for the most part they don't have palpable veins, it's a visual thing all the way. I have gleefully rejoiced the few times I went to start on IV on an infant that had a palpable vein. But nurses in the NICU still go gloveless, because that's the way they learned and they feel like the infants are 100% safe (except the known Hep B/C, HIV, whatever). I don't get it. . .
    when someone in your department gets sued, everyone will change there ways........Its sad it takes something like that to make people do whats right anyways.

    One hospital i worked at, nurses didnt check for patency all the time prior to IV pushes. Their theory was, i checked it an hour ago and it was fine then. A nurse gave so me iron IVP via an infiltrated peripheral IV, gave the lady a large permanent brown spot on her anterior forearm (Very white, pale lady). She sued and won a huge amount of money from both the nurse and hospital. SInce then everyone always checks........

    we always complain about how our country is sue happy....Well stop giving them reasons/ammo to sue.

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