I've been a nurse for 15 years in all kinds of settings-long term care, acute care, home health, geriatric case management. I recently went back to teaching CNA-1 classes and I'm confused about how the books are teaching certain skills such as bathing, foot care, hand care, and massage.
Standard precautions state to use gloves if in contact with body fluids except for sweat, and non-intact skin, when shaving a pt, when providing oral care, when providing perineal care, or if your own hands have open lesions, cuts, or injuries, etc. So why do the CNA textbooks show to wash a persons' hands and arms, wearing non-sterile gloves if that person's skin is intact and the person is not on wound/skin/contact precautions. The same book states for hand and foot care to wear gloves if there is a likelihood of coming in to contact with non-intact skin. The book states the same for a back rub. If we can touch a person's arms to take a BP or perform ROM exercises without applying gloves, then why are gloves being required to wash the same hand and arm?
My Mosby nurse skill videos I had from nursing school
show the nurse bathing the arms, hands, abdomen and back only using a bath mit. Then the nurse applies gloves to wash the lower half of the body. This is the way I've always bathed my patients on the ICU. The only rationale I can come up with is that new CNAs lack the judgment to know when they should or shouldn't use gloves.
Does anyone know what the CDC's guidelines are for this? I found a chart on the CDC website which pretty much reiterates use gloves if coming in to contact with non-intact skin and mucuous membranes or for person's on contact precautions.