Who wears gloves when starting an IV?

[DutchgirlRN]

I've been a nurse for 29 years and have a really hard time starting IV's with gloves on since I learned to do it without gloves and have been doing it for years without gloves. I try my best to wear gloves everytime but sometimes I will cut the top the finger off of the glove on my left index finger so I can still feel and then pull it up over my finger once I get a flashback. Sometimes I have an IV in before I realize that I didn't put gloves on. Old habits die hard. I was wondering if some of you older nurses have this same issue or if you younger nurses have trouble starting IV's with gloves on or are you just used to it since that's the way you learned?

[dotty865]

I have had my IV therapy certification for about 1 1/2 years. I always use gloves . But like the rest of you I do all the prep before I put on the gloves.

[Lenny]

I appreciate the tip on using the small gloves. I'll have to try it the next time. My preceptor doesn't use gloves but as a new grad it is the only way I've ever started an IV.

My problem is with tape sticking to the gloves--is there any way to get around that?

I always tear the tape off before I even start the IV. You can even tape it to the bedside rail if you want for easy access. Then assess and choose a vein. Then I don gloves and do the deed. Good luck!

[dknunges]

You should always where gloves when starting IV's ( and doing any invasive procedure!). When I learned to start IV's over 23 years ago I did not use gloves, and usually couldn't obtain them unless I was performing a sterile procedure. As difficult as it was I learned to start them with gloves on and index finger of glove intact. What helped me was I wore the smallest gloves possible which did make it a little easier to adjust. I do locate vein, prep site and get everything ready then put on gloves just prior to sticking.

In regards to tearing tape. Based on INS standard 49 only sterile tape/secure strip should go under the occulsive dressing. I no longer put it on bedrail, but tear my strips and place on the inside top of IV start pack. I can then adhere to best practice by placing sterile tape under TSM dressing.

Just my two cents

Donna

[Lenny]

You should always where gloves when starting IV's ( and doing any invasive procedure!). When I learned to start IV's over 23 years ago I did not use gloves, and usually couldn't obtain them unless I was performing a sterile procedure. As difficult as it was I learned to start them with gloves on and index finger of glove intact. What helped me was I wore the smallest gloves possible which did make it a little easier to adjust. I do locate vein, prep site and get everything ready then put on gloves just prior to sticking.

In regards to tearing tape. Based on INS standard 49 only sterile tape/secure strip should go under the occulsive dressing. I no longer put it on bedrail, but tear my strips and place on the inside top of IV start pack. I can then adhere to best practice by placing sterile tape under TSM dressing.

Just my two cents

Donna

I've read a lot of the replies for rnmi, the new grad who has trouble handling tape while wearing gloves. I'd have to agree with the overwhelming majority of that advice. Wear small gloves, they not only increase the sensitivity in your fingertips, they make it easier to handle things(including tape) if you have to do it with gloves on since there is no excess slack and they form more completely around the true shape of your hand. I also do as much prep work as possible before actually putting on gloves and doing the stick, and for me at my hospital that includes tearing the tape. The only other thing I would encourage you to do is to check your hospital policy concerning IV therapy and then adhere to it the same way you adhere to wearing gloves even though your preceptor doesn't. Kudos for you, and shame on your preceptor for demonstrating poor practice habits in front of you. Donna(dknunges) had some good tips, and it sounds like she maintains the sterility of her tape, but at my facility it's completely different. We don't place tape or occlusive dressings over IV insertion sites, so the sterility of the tape isn't an issue for us. We use a clear dressing called 'Opsite'. You can see through it, and it's sterile on the side that goes against the insertion site. It has a protective backing and a non-sterile border strip that can be safely handled with clean gloves. I personally only remove the backing when I'm actually ready to apply the dressing to the site. We only use tape to anchor, secure, or reinforce tubing and dressings already in place, so clean is allright as opposed to sterile. As you can see, policies vary widely depending on your state and facility. Check out your facilities policy. Personally, I wouldn't take the word of your preceptor by the way: If she'll violate univeral precautions then she/he probably doesn't care about the hospital IV therapy policy either. Keep up the good work rnmi, and hope this helps. Dave. :)

[terryalbright]

I've been a nurse for 29 years and have a really hard time starting IV's with gloves on since I learned to do it without gloves and have been doing it for years without gloves. I try my best to wear gloves everytime but sometimes I will cut the top the finger off of the glove on my left index finger so I can still feel and then pull it up over my finger once I get a flashback. Sometimes I have an IV in before I realize that I didn't put gloves on. Old habits die hard. I was wondering if some of you older nurses have this same issue or if you younger nurses have trouble starting IV's with gloves on or are you just used to it since that's the way you learned?

I wear gloves if my skin is really dry, if the pt. is on precautions, (yes, we still gown, glove and mask for MRSA although most of us consider it a waste of time and equipment), or if I have any (even minor) superficial cracks. The way I see it, a glove won't protect me from a needlestick and I am one who was trained without gloves. If I wear a glove I make sure it fits snugly.

[bobnurse]

I always tear the tape off before I even start the IV. You can even tape it to the bedside rail if you want for easy access. Then assess and choose a vein. Then I don gloves and do the deed. Good luck!

Just remember, no tape under the opsite.

[subee, MSN, CRNA]

You better believe I wear gloves when starting IV's where I work!

I've been working in anesthesia a long time and I know I'm "breaking the law" in my state but a rarely wear gloves to start an IV, with the exception of inmates. I don't like people snapping that latex when they draw blood on me and I only have about 10 minutes to establish any kind of relationship with my patients. I actually like to touch them skin to skin. With firm pressure on the top of the catheter there's rarely any bleeding involved.

A-lines are a different story. I wash my hands religiously after each IV and always let the patient see me drying my hands so they know I've washed. Besides, in the OR after your gloves are on for an induction, you touch the knobs on the machine and everything else so the sputal veneer is pretty thick and you're only fooling yourself if you think gloves are going to protect you. Wash, wash, wash.

[live4today, RN]

I don those gloves for EVERYTHING! I enter the patient's room, and automatically don the gloves...never know what will come out of the mouth of a patient, a vein of a patient, or the "other end" of a patient while assessing them, or simply changing an IV bag. I've had some very UNEXPECTED incidents occur, and am always glad I donned those gloves! :chuckle

Nurses...................DON THOSE GLOVES!!! Better safe than sorry! :)

[HillaryC, RN, CRNA]

My question is: Is it possible for me to develop an infection from the nurse not using gloves? As a patient, shouldn't I be able to request that my nurse wear gloves while starting/stopping my IV? Should I contact the office that she works for to let them know about this? Any info you could give me would really be appreactied. Thank you!

It's true that regular gloves (we refer to them as "clean", as opposed to "sterile") won't protect you against infection -- they're really about protecting the health care provider from exposure to bodily fluids/substances. To prevent infection, nothing should touch your skin around where the needle/IV is going to go in after your skin is prepped (including clean gloves). The only exception is when health care providers wear sterile gloves (for example, in surgery). These specially prepared gloves have nothing dirty on them, and won't contaminate the site. However, starting a routine IV does not call for wearing sterile gloves.

Regarding handwashing, it's true that some hand preps clean hands better than regular soap and water (and health care providers are more likely to use them routinely). At my hospital, we use a chlorhexidine hand "wash" (lotion) called Avagard. The ID people at the hospital say it cleans hands better than soap and water, and it's much easier to comply with. It's true that the nurse that's starting your IV should have clean hands (I don't know what the data say about Purell) -- and to protect herself, she should be wearing gloves. The bottom line is, to protect you against infection, after your skin is cleaned (ideally with chlorhexidine), nothing (hands or regular gloves) should be touching the IV insertion site. When your IV is taken out, sterile gauze should be put over the site (and again, the nurse is supposed to wear gloves to protect herself).

Hope this helps.

[bobnurse]

I've been working in anesthesia a long time and I know I'm "breaking the law" in my state but a rarely wear gloves to start an IV,

Its saddening to see that you knowingly break the rules and endanger your patients by not wearing gloves. Many healthcare professionals do not wear gloves due to a lack of education, but you are well educated and know the risks and continue to perform a task while endangering your patient. Doing so puts your patients and yourself at risk.

Lets pretend that your post makes the paper..."john doe," CRNA, performs venipuncture without gloves. Anyone that had a bloodborne infection after surgery, please call 1800-xxx-xxxx. It would make the front page. Your crazy for posting such.

You should always wear gloves, Period!

[bobnurse]

It's true that regular gloves (we refer to them as "clean", as opposed to "sterile") won't protect you against infection

They will protect the healthcare provider and patient if utilized correctly. The provider should not touch the prepped site with their "clean" gloves. Once the skin is prepped, it should not be touched by anthing except for the opsite covering it, and its sterile.

-- they're really about protecting the health care provider from exposure to bodily fluids/substances.

Its also to protect the patient from the contaminates on the nurses hands or in thier nails.

Regarding handwashing, it's true that some hand preps clean hands better than regular soap and water (and health care providers are more likely to use them routinely).

Yes and no.......Soap and water with friction continues to be the best method for removing pathogens from the hands. Many use alcohol gels, which are good, but they dont kill everything.....Like C-diff for example....

When your IV is taken out, sterile gauze should be put over the site (and again, the nurse is supposed to wear gloves to protect herself). Hope this helps.

New studies show to cover the site with opsite to prevent delayed onset air embolism, especially with central lines.

[ZZTopRN, BSN, RN]

and that will make a believer out of you!!

You better believe I wear gloves when starting IV's where I work!