Gloves Necessary For SQ Injections?

Nurses Medications

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This is going to sound like the dumbest question in the universe coming from an experienced nurse, but my ALF just had its annual corporate (not State) QA survey, and we got written up for not using gloves when giving insulin injections:uhoh3:

Now, I've been giving insulin for over a decade, but I was never taught to wear gloves for this---IMs, yes, and fingersticks, definitely, but SQ injections?? Naturally, I've never taught my staff to wear gloves for this purpose either..........so what say you all? Am I nuts for giving insulin without gloves, or is corporate all wet on this one? And how do I form a plan of correction when I think they're full of it? Inquiring minds want to know!

Specializes in Level III cardiac/telemetry.

I started allergy shots a few weeks ago and none of the 3 women who've given me my shots have ever worn gloves. One of them always wipes the little drop of blood that comes up with her hand. Grosses me out now that I think of it because I have to wonder if she wipes somebody elses blood off and then wipes mine without washing her hands.

I was taught in nursing school many moons ago to always wear gloves when doing patient care, no matter what type of care it is. The saying went, "if it's sticky, bloody or gooey and not yours......glove up." I wear gloves at all times, even changing bedsheets or re-positioning pts. Ya never know what residual may be on them. Besides, it's considered a universal precaution to protect me as well as my patients.

"This is going to sound like the dumbest question in the universe. . . . . . . . ."

Marla, thanks for starting this thread. I was taught to use universal precautions at all times. I've been exposed to just about everything known to man and so far it's worked. I'm happy to think that wearing gloves will also reduce my exposure to needle sticks. (Knock on wood; I haven't had one yet.)

Abbie

gloves should be worn anytime you may come in contact with any bodily fluids. Not so many years ago gloves weren't available like they are today so i can see where you might get confused on this one.

In school they teach you to wear gloves and it seems like all the new grads due but after time it wears off and no one wears gloves for insulin.

First, I have never heard of a cna being able to give injections, maybe she was a medical assistant or a medication aid? Yes, she should wear gloves for her protection and your childs.

I started allergy shots a few weeks ago and none of the 3 women who've given me my shots have ever worn gloves. One of them always wipes the little drop of blood that comes up with her hand. Grosses me out now that I think of it because I have to wonder if she wipes somebody elses blood off and then wipes mine without washing her hands.

I'd have a total fit if this happened to me! Btw, I am a glove-aholic.

First, I have never heard of a cna being able to give injections, maybe she was a medical assistant or a medication aid? Yes, she should wear gloves for her protection and your childs.

Maybe it was a medical assistant....I'm sorry, I didn't realize there was a difference....When I called the clinic the first time it happened (and I spoke with the receptionist at the front desk) they said... "They wear gloves for their protection, not your childs..." I thought it was strange, but what do I know???

Specializes in Vents, Telemetry, Home Care, Home infusion.

cdc makes no recommendations for wearing gloves when administering immunizations or any injections.

the cdc and osha do not call for wearing gloves unless hand contact with blood or other potentially infectious materials is reasonably anticipated (key word: “reasonably”). 1, 2

standard precautions

use standard precautions, or the equivalent, for the care of all patients. category ib

  1. handwashing
  2. gloves
  3. mask, eye protection, face shield
  4. gown
  5. patient care equipment
  6. environmental control
  7. linen
  8. occupational health and bloodborne pathogens
  9. patient placement

the cdc and osha do require the use of gloves for invasive procedures. 1

according to the cdc, invasive procedures include surgery, dental procedures, and childbirth by lady partsl or cesarean delivery 3 ; injections are not identified as such.

references

1. garner s, hospital infection control practices advisory committee. guideline for isolation precautions in hospitals . 1997.

http://www.cdc.gov/ncidod/dhqp/gl_isolation.html

2. occupational safety and health administration. enforcement procedures for the occupational exposure to bloodborne pathogens (directive number cpl 02-02-069). 2001.

[color=#003399]2001 - 11/27/2001 - cpl 02-02-069 [cpl 2-2.69] - enforcement procedures for the occupational exposure to bloodborne pathogens

3. recommendation for prevention of hiv transmission in health-care settings. mmwr recomm rep 1987;36(suppl 2s):6s–7s.

cdc recommendations for prevention of hiv transmission in health-care settings

universal precautions for prevention of transmission of hiv and other bloodborne infections

universal precautions apply to blood, other body fluids containing visible blood, semen, and lady partsl secretions. universal precautions also apply to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids.

universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable.

universal precautions involve the use of protective barriers such as gloves, gowns, aprons, masks, or protective eyewear, which can reduce the risk of exposure of the health care worker's skin or mucous membranes to potentially infective materials. in addition, under universal precautions, it is recommended that all health care workers take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices.

gloves should be worn:

  • for touching blood and body fluids requiring universal precautions, mucous membranes, or nonintact skin of all patients, and
  • for handling items or surfaces soiled with blood or body fluids to which universal precautions apply.

gloves should reduce the incidence of blood contamination of hands during phlebotomy, but they cannot prevent penetrating injuries caused by needles or other sharp instruments. institutions that judge routine gloving for all phlebotomies is not necessary should periodically reevaluate their policy. gloves should always be available to health care workers who wish to use them for phlebotomy. in addition, the following general guidelines apply:

  1. use gloves for performing phlebotomy when the health care worker has cuts, scratches, or other breaks in his/her skin.
  2. use gloves in situations where the health care worker judges that hand contamination with blood may occur, e.g., when performing phlebotomy on an uncooperative patient.
  3. use gloves for performing finger and/or heel sticks on infants and children.
  4. use gloves when persons are receiving training in phlebotomy.

cdc's universal precautions for prevention of transmission of hiv, hepatitis b virus, and other bloodborne pathogens in health-care settings -

Specializes in Level III cardiac/telemetry.

OMG - did that really say that universal precautions don't apply to feces? What about the hep risk? What about the gross factor?!

Interesting that I ran across this forum today....I gave lovenox sq the other day and we were switching the pt from heparin to the lov. sq injections....must have hit a capillary bc she bled when I withdrew the needle. Thankfully I had gloves on. I was taught to wear gloves for virtually everything except a fart (a little exaggeration there). Has anyone ever heard of studies on gloves offering some protection against acquiring hepatitis or HIV on accidental sticks? I had a pathophysiology professor who talked about the gloves actually benefiting you if indeed you were stuck with a contaminated needle. Just something to ponder..I realize the risk would be sort of low from a sq injection but you never know! :)

Specializes in Emergency Dept, M/S.

I wear gloves for everything. Not only because that is what I was taught, but because I'm diabetic and have tiny holes from my glucose checks in my fingers, and want to protect my patients as well as myself.

I have a friend that gloves whenever he touches anyone. He was taking a b/p one time and the pt, unbeknownst to my friend, ended up being a very "clean cut" heroin addict, with fresh track marks. Taking the b/p apparently dislodged a fresh scab or something, and the pt started bleeding. I don't know if he ever found out the pt's HIV or Hep status, but that did it for him.

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