Gloves? Is this acceptable?

[medsurgRNCali]

I know we are suppose to use gloves for everything. And I always put gloves on as soon as i go into the room , but I have seen many nurses not use gloves if they are just passing a oral med. Is this acceptable? In reality you are not touching the patient, you scan his band, scan the med and put it in the med cup. I can see why they wouldn't use gloves, it seems it would be easier to open those dang pills without them! But isnt this frowned upon?

[kbrn2002, ADN, RN]

When I was in nursing school we were taught to use gloves anytime we could come in contact with bodily fluids. Otherwise don't as human touch is an important part of care and the use of gloves when not needed could possibly make the patient feel "dirty." I only mention this because while use of gloves was taught, the out of date training videos they used showed nurses carrying full bed pans down a hall to the utility room with bare hands. Yikes! That is wrong on so many levels, yet since those videos were still in use as teaching tools it obviously wasn't long before that this was considered acceptable practice.

[psu_213, BSN, RN]

First, to the OP, don't be sorry at all!

Didn't we just have a long discussion here a few months ago about whether or not it is necessary for a nurse to glove every time he/she goes into a room?

Not meant to offend anyone, but I find it curious that people think that it is protective for the patient if they use a bare hand to grab gloves out of an open box sitting in the room and then touch the patient with said gloves.

[osceteacher]

First, to the OP, don't be sorry at all!

Didn't we just have a long discussion here a few months ago about whether or not it is necessary for a nurse to glove every time he/she goes into a room?

Not meant to offend anyone, but I find it curious that people think that it is protective for the patient if they use a bare hand to grab gloves out of an open box sitting in the room and then touch the patient with said gloves.

An interesting study showing that as much as 80% of gloves in a non sterile box had elements of bioburden. And another here on ortho wards.

It was quite interesting to see a study on non sterile v sterile in certain dermatology procedures and there was no difference in wound infection rates, that surprised me a bit.

[JKL33]

Not to be dense here, but doesn't all of this data regarding contamination of non-sterile gloves pretty much simply demonstrate that they can harbor and therefore (potentially) transmit bacterial CFUs just as bare skin can?

So that the bottom line is still hand hygiene?

In my fantasy world:

Go into room, wash hands, put on pair of gloves, preferably ones that securely cover the wrists. Leave them on and continue to perform hand hygeine at the times you would usually perform hand hygiene as you move about the room/patient according to accepted standards. Take them off when you're all done and wash your hands again.

Seems like the best of both worlds. But that's me wondering/suspecting that contaminated gloves should be easier to clean (while worn) than contaminated skin. I'm sure we've all done the fun little experiment of which shows that your hands remain contaminated even after an episode of extra-diligent hand hygiene (due to knowing you were being tested).

Plus I just really enjoy gloves. They make me feel good about maybe getting less general filth on myself than I otherwise might have. I do my best not to spread my own skin or glove filth around. My science on all if it is pretty soft but definitely comparable with the science involved in enough of the other stuff I do.

[Yeah - I'd love to wear them in the grocery store, too, and any time I'm forced to walk in the general direction of a public restroom. I still don't think my personal scientific incongruities with respect to this are a whole lot worse than the average of what I observe around me.]

[mtmkjr, BSN]

I work with nurses who lay a towel on chairs every time they sit down. They leave the towels behind when they walk away. Just last week I noticed one of them scooting her shoes on some purple wipes at the end of shift. I think it's just silly, and a bit irrational.

I only glove when actual contact with body fluids is expected and if I can't grab a pair in time, I don't freak out, I just wash more vigorously. I'm a firm believer in the power of soap and water, the protective barrier of one's own integumentary system and keeping a healthy immune system.

(Needle sticks aside) I don't see any evidence that nurses are acquiring infections and illness from their patients. as long as they follow basic universal precautions with additional isolation precautions as indicated.

(Side topic: I know this is comparing apples to oranges, but I also raised my 3 kids with a healthy exposure to dirt and we have zero allergies/food sensitivities, and get sick very little. I believe the evidence is getting stronger connecting sterilized living spaces to auto-immune disorders, asthma, allergies and the like)

[BonnieSc]

We have several places in each patient room that are DESIGNATED "glove free zones". If you put on gloves on entry, you'd be breaking policy. Unless you take off those gloves, wash, get what you need, rewash, reglove... this includes the keyboards, by the way. Theoretically we can get cited for using a computer with gloves on (outside of isolation).

We were recently informed, though, that our medication practices are going to be audited by some accrediting agency (I don't remember what) and they told us ("reminded" us) we're supposed to use gloves when handling any medications, including oral. I try not to touch pills with my hands, but it hasn't been my practice to wear gloves when giving orals.

Every hospital is different. One I worked at designated IV ports/lines as "glove free" zones (unless obvious blood or chance of blood); my current one says we have to use gloves when giving IV meds.

[Medic_Murse, BSN, RN, EMT-P]

Am I putting my hand in the patient's mouth? I mean I don't, but if I'm suppose to be, I am F'in this job up hard!

[Here.I.Stand, BSN, RN]

Totally understandable.

I guess from my perspective watching a variety of nurses in a variety of clinical settings throughout the world I do not see extreme caution and barrier use being a problem, usually the lack of caution and lack of barrier use altogether.

I don't think any of us advocate touching slimy NGs or picking dried blood with bare hands. That would fall under my earlier "reasonable expectation of bpdily fluids" comment... my strong stomach turned when reading your other post!!

Wishing you a speedy recovery btw... if I understood correctly that you are sitting in the CVICU as a pt.

Speaking for myself, I absolutely don gloves for things like that -- or touching the pt's face or bedding (unless I know that bedding is fluid-free.)

I don't don them the moment I walk into the room however. I'm not a flaming tree-hugger, but I do my part where I can. Keeping clean gloves out of the landfills/incinerators is one of those things... and if I don gloves to answer a question or silence a false VT alarm or turn off a light... those are clean gloves getting thrown away.

Besides, how often do we don gloves when entering Wal Mart?? There are probably waaaaay more ickies in Wal Mart than on on IV pumps or in the hospital room air (which is the same as hospital hallway air, unless a neg airflow room)

[LovingLife123]

Um, okay. You sound a little defensive, there. I was just kind of hoping for a science-based rationale for your practice. Guess not. If you're so vehemently opposed to discussing your rationale, I'm a bit confused why you would bring it up in the first place. Surely you knew people would ask.

I was taught to always glove up. Not just in nursing school, but on my unit. I'm not defensive, it just irritates me when people respond the way they do like those of us that glove up all the time are crazy or something. I was always taught, especially when passing meds, you glove up. And I understand the rationale. I can palpate pulses just fine with gloves. I can hear through my stethoscope fine while wearing gloves.

You never know when you will come into contact with bodily fluids. I've had vomit come across the room to my eyes and hair before. I've had people spit on me. I can do a skin inspection and find a whole bed of liquid stool. I can look at a catheter during my head to toe and find the patient has pulled it out. I've had patients pull out their catheter and hand it to me when I come in the room.

So yes, I'm gloving up. Every time.

[LovingLife123]

No need to be defensive. As I said it was a serious question. It just seems to be pointless for general patient contact.

Have you ever cultured the computer keyboard you use at work? Now those are scary! Unless you glove for every contact for every surface you come in contact with at work I don't see how gloving to reset an IV pump or answer a question makes a

difference. But there's no harm in it so you do you!

That's why I bleach my keyboard and claim my computer at the beginning of the day. I actually bleach the whole nursing station at the start of my shift.

I grew up in the dirt and played outside as a kid. I've got a decent immune system. But I also have a family. I'm not tracking all those germs home to my infant.

[CapeCodMermaid, RN]

Gloves should only be worn when there is the possibility of exposure to any body fluid. Why wear gloves when passing meds? It doesn't make any sense whatsoever.

[LovingLife123]

I'm guessing many of you that don't glove up work on a med surg floor or outpatient. When you work in the icu, literally every encounter you can come into contact with bodily fluids. It's a different world. I have to do oral care and suctioning. I have to pass meds down feeding tubes. Many patients have chest tubes and drains. I'm always in contact with fluids.

I suppose if I had alert and oriented patients that could toilet themselves it might be a different story. Very few of my patients can even swallow. I have to push IV meds constantly and have drips to hang. I'm gloving up for all of that.

When I do oral care, I turn. Therefore, gloves are worn. Most of my patients are incontinent. I clean them up when I turn. Turns and oral care are every two hours.

The nature of the ICU requires gloves.

I'm not sure why that's a hard concept to understand.