Contact precaution question

I have done the same thing, and was wondering about this too. If it's contact precaution, I think that technically, you're right, as you protected your hands, that were the only part of you to come into contact with anything in the room.

I'm interested to see what others have to say.

If the wound is covered and you are going in for the PICC only and gloving I would think that would be okay. You could check with the ID docs in your hospital to be sure, if you want an answer without going to the skin/wound team.

Contact precaution require wearing a gown regardless if you're going to have contact with the infected area or not. NB remember the elements travel up to 3 feet.

I'd say gown up any time going in the room. In Tthe places I've been, this is the policy that has been enforced -stringently-, as well. You never know what you're going to run into once you're in there. You might end up being in there longer than a minute and come in more contact with the patient than you expect. And if surveyors come in and see you ungowned, how can you prove you were 'just in there to flush the PICC'? Just my take

Also, if it's contact precautions, why do you need a mask?

No idea.

Does it really take that long to throw on a gown? As health care leaders we are here to set an example...cutting corners to save 10 seconds doesn't show much leadership.

It was not about saving 10sec., it was asking what is okay to do in that situation. As you can see several others have done the same in the situation, and I am sure that has nothing to do with our leadership abilities.

As the infection control nurse for a large hospital, gown and gloves are what we require for all patient contact with the patient and the patient care environment. The CDC has regs on this: http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf

Its long, but actually very interesting. It is nice to see the rational for everything and compare it to you hospitals practices.

With taht said, as an ICU nurse also, I hate having to gown and glove. this infection control position has really opened my eyes.

It was not about saving 10sec., it was asking what is okay to do in that situation. As you can see several others have done the same in the situation, and I am sure that has nothing to do with our leadership abilities.

But breaking the rules does. Just because others have done it doesn't make it right. My opinion is obvious, the rules are there for a reason, it doesn't matter if you are only going in to flush a PICC (which involves pt contact and potential fluid contact), or do a dressing, put the gown on to protect the rest of your patients.

Any contact with the patient or "potentially contaminated areas in the patient's environment" is supposed to involve gloves and gowns, so contact with the PICC should include contact precautions. (per the CDC).

That being said, we need to be careful to use precautions only when truly indicated and not be unnecessarily cautious because there is a downside to isolation. There is evidence to show that patients on isolation have worse outcomes than if they were not isolated due to impaired patient care (staff tend to avoid isolated patients).

While I'm not yet convinced we should just give up, many hospitals actually no longer isolate based on the lack of evidence that it provides any benefit except in the case of acute outbreaks.

No, it was not okay to just throw on gloves for capping and flushing a PICC line. While the MRSA infection may have started in the wound, unless you have instantaneous blood cultures from that day there is no telling that it didn't spread to the blood. Or that the patient had not accidently touched their wound to the side of their bed against which you may have brushed your clothing. You clearly know the rules - gown and glove (never heard of mask for contact iso pts unless you were planning on a procedure where something may splash at you) just follow them.

Our hospital only requires gloves for contact precautions, unless it is CDIFF, then we have to gown and glove. No mask unless it is airborne precaution. i see people going in with no gloves, but washing before they leave stating "it's only history of MRSA" or how many people do you think come in here that have MRSA as visitors? It is a lose/lose battle in my opinion; yes there is some control, but there is never full control unless P&P are adhered to 100% of the time by 100% of the staff and that is highly unlikely. All it takes is one person to go in without PPE and come out and contaminate other surfaces...