All out of Sterile Gloves

[anitalaff, BSN, RN]

I am in an ambulatory clinic and we are on our last box of sterile gloves. Does anyone here have experience with trying to be aseptic without sterile gloves? We do a lot of PICC and VAC dressings. I can't find any best practice documents that address a lack of resources. If you know of any references, please let me know.

[eerrmm]

I'd look to see if medical relief organizations like Doctors w/out Borders or maybe the WHO has guidelines on using exam gloves for a usually sterile procedure.

[namaste111, BSN, RN]

Have you tried buying them online from sites such as Alibaba? They sell them in bulk.

[anitalaff, BSN, RN]

On 3/27/2020 at 9:09 AM, eerrmm said:

I'd look to see if medical relief organizations like Doctors w/out Borders or maybe the WHO has guidelines on using exam gloves for a usually sterile procedure.

HI eerrmm, I have looked through WHO sites and documents. I posted my comment in the hope that someone else has seen a resource that I have missed.

[anitalaff, BSN, RN]

On 3/27/2020 at 12:35 PM, namaste111 said:

Have you tried buying them online from sites such as Alibaba? They sell them in bulk.

Alibaba sellers have a lot of trouble differentiating between clean and sterile gloves. Has your agency bought medical supplies through this site before?

[hppygr8ful, ASN, RN, EMT-I]

I understand the need for sterile gloves for picc dressings but having been treated for diabetic wounds with negative pressure systems I have never had the nurse use sterile cloves - in fact it has been treated as a clean procedure not a sterile one. I even changed my vac dressings at home by myself or had my 17 Y/O son do them with minimal training. I would suggest that using sterile supplies when not needed for "Clean Procedures" greatly contributes to the problem of shortages.

Hppy

[anitalaff, BSN, RN]

3 hours ago, hppygr8ful said:

I understand the need for sterile gloves for picc dressings but having been treated for diabetic wounds with negative pressure systems I have never had the nurse use sterile cloves - in fact it has been treated as a clean procedure not a sterile one. I even changed my vac dressings at home by myself or had my 17 Y/O son do them with minimal training. I would suggest that using sterile supplies when not needed for "Clean Procedures" greatly contributes to the problem of shortages.

Hppy

Hi Hppy;

First of all, we are not wasting sterile supplies on procedures that are often done with clean technique. My question, which I will reword: What happens when you have no sterile gloves for procedures that must be asceptic for patient safety?

[hppygr8ful, ASN, RN, EMT-I]

6 hours ago, anitalaff said:

Hi Hppy;

First of all, we are not wasting sterile supplies on procedures that are often done with clean technique. My question, which I will reword: What happens when you have no sterile gloves for procedures that must be asceptic for patient safety?

I didn't mean to say it was wasted simply that many times sterile gloves are not needed for procedures that need only be done by clean technique. I posed the question to our infection control nurse of the best course of action should no sterile gloves be available and a procedure needed to be done. She said and I quote "Very Carefully." she went on to say that if a dressing absolutely needed to be changed and sterile gloves were not available the nurse should clean their arms from elbows to fingertips with a good surgical scrub such as Hibicleanse and do the best they can. The alternative is to leave a soiled dressing in place which also puts the patient in danger of infection. She also noted that there is a difference degrees of aseptic technique from simple asepsis up to surgical asepsis.

Hope you get some glove soon - we have crates of them that we never use as we are psych. I'll trade you some for case of N95s if you got them.

Hppy

[anitalaff, BSN, RN]

48 minutes ago, hppygr8ful said:

I didn't mean to say it was wasted simply that many times sterile gloves are not needed for procedures that need only be done by clean technique. I posed the question to our infection control nurse of the best course of action should no sterile gloves be available and a procedure needed to be done. She said and I quote "Very Carefully." she went on to say that if a dressing absolutely needed to be changed and sterile gloves were not available the nurse should clean their arms from elbows to fingertips with a good surgical scrub such as Hibicleanse and do the best they can. The alternative is to leave a soiled dressing in place which also puts the patient in danger of infection. She also noted that there is a difference degrees of aseptic technique from simple asepsis up to surgical asepsis.

Hope you get some glove soon - we have crates of them that we never use as we are psych. I'll trade you some for case of N95s if you got them.

Hppy

I'm sorry Hppy. I got rankled and you didn't deserve that response. You know, my infection control nurse said the same thing, but I just didn't want to accept it. OMG explaining this to clients who know darn well why we use sterile gloves was an experience. Also, many logistical problems arose from having to walk away to scrub in.

I'm going to review simple asepsis and see what's what. Thanks for doing my homework.

[hppygr8ful, ASN, RN, EMT-I]

2 hours ago, anitalaff said:

I'm sorry Hppy. I got rankled and you didn't deserve that response. You know, my infection control nurse said the same thing, but I just didn't want to accept it. OMG explaining this to clients who know darn well why we use sterile gloves was an experience. Also, many logistical problems arose from having to walk away to scrub in.

I'm going to review simple asepsis and see what's what. Thanks for doing my homework.

Honestly when I had my first non-healing wound back in 2012 (Which BTW was how I found out I was diabetic) I asked the first wound care nurse I had if she shouldn't be using sterile gloves. I got an education that day for sure. Since I have learned a lot and also embrace my role as a patient educator to help people understand what is and is not required. I remember my first nursing job in L&D when we were laying out a delivery set up and I said shouldn't this stuff be sterile. My preceptor said "We give the docs sterile gloves but birthing is considered a clean procedure and after you see al the poop and blood you'll wonder why we even call it clean!"

[Wuzzie]

We have dressing change kits that come with sterile gloves. You might want to ask your supplier if they have that availability. Full disclosure, ours are custom but there may be commercially available kits out there.

Look what I found. there are other suppliers as well. Bard is the company we use.

https://www.bardaccess.com/products/stabilization/dressing-change-statlock

[anitalaff, BSN, RN]

8 hours ago, Wuzzie said:

We have dressing change kits that come with sterile gloves. You might want to ask your supplier if they have that availability. Full disclosure, ours are custom but there may be commercially available kits out there.

Look what I found. there are other suppliers as well. Bard is the company we use.

https://www.bardaccess.com/products/stabilization/dressing-change-statlock

Hi Wuzzie;

Funny you should mention that because that was the first thing we asked. You should have seen the manager's face while she thought about the cost. Honestly though, we have no qualms about pilfering some of those kits for sterile gloves. It's just that we don't have many in stock. It feels like a dumb thing to obsess about in the middle of a crisis for N95s (which we also don't have) but we have a lot of clients on chemo with PICCs and want to keep them as safe as possible.