Gloves Necessary For SQ Injections? - page 4

by VivaLasViejas 23,285 Views | 67 Comments Guide

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... Read More


  1. 0
    Quote from LanaBanana
    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.
  2. 0
    Quote from tlp12
    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???
  3. 0
    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 vaginal 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 vaginal 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 -
    Last edit by NRSKarenRN on Jul 24, '06
  4. 0
    OMG - did that really say that universal precautions don't apply to feces? What about the hep risk? What about the gross factor?!
  5. 0
    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!
  6. 0
    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.
  7. 0
    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.
    It's that reason why if the person giving me a shot isn't wearing gloves, i'll request it.
  8. 0
    Yep, I wear gloves. Err... actually make that glove... I only wear 1 glove and it goes on my nondominate hand. I'm only refering to injections and not things like enemas.
  9. 0
    I recently spent 5 days as a patient in a big city hospital-very highly rated. I was getting IM Thiamine injections. Boy do they hurt. All the nurses wore gloves. Onw experienced nurse began to give it to me without gloves. I asked her to put them on. During the injection, she pulled the needle out and reinserted the same needle. I questioned this, and she said she didn't do that. I remember an instructor sending me back five times for a new needle, because I couldn't get it in the first time. the lady was very old , and her arms were very thin. Should I have questioned both insidences? After I did ask her, she brought my pain meds an hour late each time. I questioned the doctor, and he said they have withn an hour to give meds. He must have told her, because all she said to me for the next five days was "What?" everytime i rang my bell. Was I wromg to question her actions? I wear gloves for everything. I was taught that in my refresher class. One student refused to give a wound treatment with gloves. I ignored her and wore my gloves. The man ended up having MRSA. There is a reason for wearing gloves called infectious disease, and I don'yt like to have to tell a fellow nurse to wear them. I had another nurse in a doctor's office try to take my blood without gloves. She did not like me telling her that she had to wear them. With HIV, Hepatitis, MRSA, etc., why do the nurses who don't want to wear them feel that they are immune to catching or giving a disease? Krisssy
  10. 0
    gloving policies
    cdc has recommended that hcws wear gloves to 1) reduce the risk of personnel acquiring infections from patients, 2) prevent health-care worker flora from being transmitted to patients, and 3) reduce transient contamination of the hands of personnel by flora that can be transmitted from one patient to another (354). before the emergence of the acquired immunodeficiency syndrome (aids) epidemic, gloves were worn primarily by personnel caring for patients colonized or infected with certain pathogens or by personnel exposed to patients with a high risk of hepatitis b. since 1987, a dramatic increase in glove use has occurred in an effort to prevent transmission of hiv and other bloodborne pathogens from patients to hcws (355). the occupational safety and health administration (osha) mandates that gloves be worn during all patient-care activities that may involve exposure to blood or body fluids that may be contaminated with blood (356).


    (this is from 2002)

    http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm
    Last edit by Otessa on Jul 24, '06


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