Do you put on sterile gloves?

[IsseyM]

I've been precepting with different nurses and notice that when they use Choraprep or Duraprep some will use sterile gloves and some will not. The nurses who don't use sterile gloves told me the their rationale is that they are not touching the end of the applicator that is on the skin, they are only holding the handle. The nurses who do use them tell me all preps require you wear sterile gloves because you have the chance of your unsterile hands contaminating your prep. What do you all do and what is your rationale. Just curious.

[mikethern]

nevermind

[Marie_LPN, RN, LPN, RN]

>>

Of course you will. So will I. The difference is that you don't realize that it is unnecessary.

It's quite possible to give an opinion/disagreement without being personally insulting or rude, FYI.

[Marie_LPN, RN, LPN, RN]

In addition, regarding the sterile gloves for prep: i've seen people i've worked with go to get a pair of regular exam gloves out of the box on the wall, 10 more gloves tumble out and into the floor, and the person getting the gloves picking them right up off the floor and either putting them in their pocket or putting them right back in the box (yes i've spoke up abouot it, but who's to say it doesn't happen). At least with sealed sterile gloves, i have a better idea of where they were last then the exam gloves.

[SmilingBluEyes]

It's quite possible to give an opinion/disagreement without being personally insulting or rude, FYI.

I agree, so let's stop this here.

If anyone is attacked and/or insulted by another poster, please, instead of responding directly, ONLY report it, using the red triangle at the bottom left of the post. Let the staff take care of rude and inflammatory posts and members.

Thank you.

[mikethern]

It doesn't make sense to wear sterile gloves during a prep if you don't wear a sterile gown. A circulator's forearm is dirtier than exam gloves.

[Bibagirl]

It doesn't make sense to use sterile gloves when using a dura prep.

What makes better sense is that the nurse washes and dries his/her hands

immediately before prepping!

[mcmike55]

For basic abd preps, I normally don't wear sterile gloves when using a Duraprep. Along the line of the old fashion sponge stick, hands off method.

When doing extremities, such as hands for carpal tunnels, ankle fx's, etc, I definitly wear sterile gloves. I have to hold in the prepped area, and feel I have better control of the extremity.

I'm also try to maintain awareness that any prep solution that run from unsterile to steirle. It can happen.

mike

[mikethern]

I'm also try to maintain awareness that any prep solution that run from unsterile to steirle. It can happen.

What do you mean?

[TracyB,RN, RN]

This is in response to switching blades....We've been getting some really crappy ones lately, so our docs are frequently switching blades to "stay sharp." One doc referred to our new blades as "hacksaws" & wants a fresh one after each time a blade is used. They really are that bad!

[ewattsjt]

i think that mike's statement is referring to the idea that skin knives are considered contaminated because it cut the skin. some surgeons use a “skin knife” and a “deep knife”. mike's point is that if the skin is contaminated for the knife to touch it, it would also contaminate your gloves by touching the skin as well as your sponges, bovie, etc...

newer studies suggest that the skin knife vs. deep knife is unfounded. the infection rates stay approximately the same if changing knifes or not.

[crackerjack]

The issue is not with initial counts. The issue is with closing counts. If you can fit a lap sponge into a 5mm incision, then you should be performing magic in Las Vegas.

Wild one for ya...I work with an RN who had a surgeon shove a ray down a 5mm lap port. When she saw what was going on she about messed her pants, naturally!! I don't recall what she said his purpose and rationale was, just that he got it out the same way he put it in. So even with a 'guaranteed no-open laproscopic case' you have the risk of dumb-orifice moves like that. (not that there is any such thing as a 'guaranteed no-open laproscopic case')

[mikethern]

Wild one for ya...I work with an RN who had a surgeon shove a ray down a 5mm lap port. When she saw what was going on she about messed her pants, naturally!! I don't recall what she said his purpose and rationale was, just that he got it out the same way he put it in. So even with a 'guaranteed no-open laproscopic case' you have the risk of dumb-orifice moves like that. (not that there is any such thing as a 'guaranteed no-open laproscopic case')

It makes total sense to count instruments and other before a laparoscopy since you might open.

You shouldn't have to count at the end of a say a percutaneous pinning for example.