Universal precautions not really universal, are they?

[Purple_Scrubs, BSN, RN]

It really blows my mind when I see lay people cleaning wounds and such without any type of PPE. I am talking about people unrelated to the child, of course. I have seen a teacher come to my office pinching the nose of a student with a bad nosebleed. (There was no reason the student could not have pinched his own nose!) I have also seen a random parent cleaning a minor (but bleeding quite a bit) head wound, and this was not the student's parent, just a totally random parent. The kicker there was they were cleaning it out in the water fountain. I also have parents who scoop their injured kid up and carry him to my office give me a dirty look when I put gloves on before touching the child.

Now I'm not ridiculous about it, I put plenty of bandaids on without gloves and even will clean very minor wounds sans gloves, but if there is any amount of blood that has any danger of soaking through the cotton ball to my skin, I glove up.

I guess as a daughter of an RN I grew up knowing about universal precautions. Maybe it should not surprise me that not everyone knows/cares about this??? Maybe it is because it deals with children and people assume you can't "catch" anything from them???

Am I alone in my shock over people who are willing to wallow in the bodily fluids of others?

[bergren]

It is usually the nurse's role to teach BBP in schools. Are you the one teaching universal precautions or is it someone else's job to fulfill this annual OSHA requirement in your school ? What is it about that training that you need to change to get better outcomes? It sounds like a workshop for the PTA might be in order too.

Honestly, you should be writing an incident report each time you see a teacher or a parent violate universal precautions because it is a body fluids exposure. It is huge liability issue for the district - there is far more likihood of transmitting hepititus than anything else.

Most states have standard materials to use for the trainings - are your state's materials stale? Or are people getting complacent?

[mustlovepoodles, RN]

Not only do I see lay people doing this, I recently saw it in an ER. We were in a terrible wreck about a month ago and the whole family ended up in the ER(none of us hurt too badly.) My DD17 had a cut that was bleeding enough to need stitches, though. When the nurse started cleaning it with her bare hands and some saline-soaked gauze I immediately stopped her and suggested that she put on gloves. Her answer stunned me--"Oh, this is nothing compared to some of the stuff I see." I said to her, "I'm sure thats true but you have no idea if this child has Hepatitis, do you?" She shrugged her shoulders and said, "Nah, she looks okay to me." So I told her I really wanted her to put on gloves to protect my daughter from *her* germs. She just rolled her eyes and walked off. Thankfully, the doctor took over, wearing beautiful purple gloves, cleaned her up and stitched her. I wrote a letter to the CEO about our experience and I named names.

I don't know how to get our teachers on board with the gloves. They just don't think about blood and body fluids, or at least they don't think that one of *their* kids could be infected. Every year I have an inservice with the staff to reiterate the necessity of using gloves if they just MUST touch a bleeding or barfing student. ANd I give each teacher a baggie full of bandaids, gauze pads, and gloves. But I have never seen a teacher don the gloves. They just don't get it.

[schoolnurse09]

Interesting timing. Just yesterday I had a teacher in my office explaining to me that teachers will follow universal precautions only if they know a child has a blood borne illness.... what?!! Over and over, I explained that "Universal Precautions" means you use it all the time- no matter who the student is (or staff, for that matter).... A Universal Precautions power point viewing is required of all new staff, I give the information in a staff meetings, I reinforce the material. Basically, she was telling me that the protocol won't be followed, unless they have knowledge of illness...that, by the way is her basic argument for the staff to be able to know what child has what blood borne illness... I could not get the concept through her head. I am very frustrated by this. So, I totally feel your pain.

[Purple_Scrubs, BSN, RN]

It is usually the nurse's role to teach BBP in schools. Are you the one teaching universal precautions or is it someone else's job to fulfill this annual OSHA requirement in your school ? What is it about that training that you need to change to get better outcomes? It sounds like a workshop for the PTA might be in order too.

Honestly, you should be writing an incident report each time you see a teacher or a parent violate universal precautions because it is a body fluids exposure. It is huge liability issue for the district - there is far more likihood of transmitting hepititus than anything else.

Most states have standard materials to use for the trainings - are your state's materials stale? Or are people getting complacent?

We used to teach it, but not it is done by computer module... I seriously doubt anyone really pays attention to it. That is a good idea about writing up an incident report, though. Maybe that would get someone's attention. I think people just don't think that kids could possibly give them anything. Sadly, they are wrong.