Topical med administration

Nurses Safety

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I work in a treatment center where there are about 80 adolescents in 7 different buildings.

The direct care staff, after being trained by an RN, administer the medications, and the RN periodically observes them doing it, and on occasion administers the medications to some of the buildings.

These are kids who are pretty much in a foster care type of situation, but with behavior problems and or mental health issues.

When I give the meds, I administer the pills into a paper med cup, and ensure that they are swallowed, and then i put any topical's they have....

benzoyl peroxide, desenex foot cream or powder, hydrocortisone cream or retin a gel and those type things... in a paper cup, and let the resident do their own, unless they need help, ie putting it on their back.

If I'm going to be administering it directly to the resident, i'll put a glove or 2 on, unless i'm just using a cotton swab to do it.

But if the resident is doing their own, I never put gloves on just to put the ointment into the tube.

Several months ago, some of the teens decided that I needed to wear gloves even to put pills from blister pack's into their med cups. (they were just being difficult teens) and they asked for a meeting with my boss to discuss it.

She told them that no, i should not glove for pills, but that I should glove for administration of topicals....

Even just putting a small dab into a paper cup for them.

Since this is a residence, and not a formal hospital setting, i'm a bit confused as to the rationale behind it.... my boss :angryfire acted like she was totally shocked that i'd not glove for that and didn't give me any rationale.... she does know that i was talking about just the dab into the cup, not putting it on the skin.

The only cream that I ever remember gloving for.... was when i had contact with nitro paste because it could be absorbed into my skin.

Thoughts?

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I agree with you. I'm also confused as to why you should glove to put a cream into a cup. You are not acutally touching the cream or ointment.

I don't understand. Is your boss an RN?

I also work in a place where a few of the people can put on their own ointments, creams, and I don't glove up to give it to them.

That's ridiculous. Someone is just trying to make it hard on you, and your boss doesn't care. Do the teens think you're touching the cream or ointment?

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I agree with you. I'm also confused as to why you should glove to put a cream into a cup. You are not acutally touching the cream or ointment.

I don't understand. Is your boss an RN?

I also work in a place where a few of the people can put on their own ointments, creams, and I don't glove up to give it to them.

That's ridiculous. Someone is just trying to make it hard on you, and your boss doesn't care. Do the teens think you're touching the cream or ointment?

My boss is a diploma RN, who's been in the nursing workforce for about 25 - 30 yrs.

I have my RN BSN, and part of my MSN in psych mental health nursing, and have been working in nursing since 1981. ie 23 yrs.

the kids are just being difficult lol

but that's why they are placed with us....

the problem comes into play when my boss says

oh yes wear gloves to dispense hydrocortisone cream, benzoyl peroxide, and or vaseline and or neosporin oint etc.

And of course wash hands prior to gloving.... then take gloves off after doing the 1 kids oint, then wash hands, then glove to dispense the next kids cream, then taking them off, and washing hands again etc.

IF I was to do that.... it would take me double the length of time to do the meds.... and it would be a dangerous situation because i'd have to keep going to the sink, which would mean i'd have to either lock all the meds up in the closet, and or i'd need to at least lock the office i work in.

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Specializes in Utilization Management.
And of course wash hands prior to gloving.... then take gloves off after doing the 1 kids oint, then wash hands, then glove to dispense the next kids cream, then taking them off, and washing hands again etc.

We were taught to use alcohol or antibacterial gel up to five times in between hand washings on a straight med pass.

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We were taught to use alcohol or antibacterial gel up to five times in between hand washings on a straight med pass.

But that was in an acute medical setting right?

This is more like a foster home.

When I move from one cottage to the next, i wash my hands again.

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Specializes in Utilization Management.
But that was in an acute medical setting right?

This is more like a foster home.

When I move from one cottage to the next, i wash my hands again.

No, it was a LTC setting with 30 patients of all types.

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