Neurotic or Not?

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Specializes in ER, Research.

I drew blood today, and I washed prior to the blood draw and used 2 alcohol swabs on the patient. I ripped off the index finger of my glove to feel the vein better, and then swabbed my index finger w/ alcohol before touching the pt's skin. I felt my index finger ever so slightly touch the needle right before I punctured. Is this an infection concern or am I being overly neurotic?:(

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Okay if any it is a slight...very slight risk. Did you puncture YOUR skin (that increases the risk).

Since you used alcohol on the area of stick, and your finger...I don't think it is very riskly because lets face it...how many of us will touch the tip of the cannual/needle with part of our gloves and not feel/notice??? Proably pleanty of times! I think a glove that has been exposed far more is more dangerous than a finger you used alcohol on! But thats just me!

It happens though, and you just try to really watch what you do and keep it as clean as possible. This is a clean procedure not a sterile one with sterile field and what not (even though it is cool to keep things as totally sterile as possible, but sterility is almost impossible in pt rooms as is).

As far as you...if you didn't touch the blood, and didn't puncture your own skin you are good to go. Pt...such a low risk that it worth you being upset...just learn from it and watch that cannula/needle tip carefully.

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You're fine, just be diligent about not doing it again.

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Specializes in ER, Research.

I'm not worried about me, b/c it was before I stuck the patient. There wasn't any blood yet. I'm worried about giving the pt an infection, i.e. staph, MRSA, sepsis....etc. I'm so anal that when I feel I've screwed up I feel sick over it. :(

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Okay...Triage is going to go mother nursie on you now! LOL!

One...ALWAYS be worried about yourself! Not only do you need to keep away from unsafe practices for your own well being, your family...but from pt to pt you get in contact with..and that is under your control. And you are no good to anyone if you get harmed/sick! So readjust your thinking...respect yourself and keep yourself safe or you do nobody any good!!!

Second...Don't freak! Like I said...more probelms actually happen from gloved hands not feeling when they have touched a contaminated area! Say you are lining up your stick, but your fingers brush the outside of the alcohol prepped area? Oopsie huh? And that happens all the time...heck try being a paramedic...clean is so subjective dependant on situation! You do what you can in those cases...clean or not (even though you try your darnest) because that IV will save the person and we can treat infections afterwards! Priority!

YOu swabed your finger! Good show! And remember back in micro about natural flora on pts skin...you risk more from a persons own bacteria than your own in most cases! You made a entry with the needle exposing the body to their own bacteria...even if alcohol swiped (do you recall if you touched the cannula/needle elsewhere or perhaps not where you wiped). Don't fret it...because the risk that happened from your incident was so much safer then most IV sticks on a good day!

You weren't doing a central line or picc...so relax a bit...this is not a sterile technique. You start doubting yourself on a IV stick...it will grow to other areas and then you will not trust yourself on anything..and what good is that to anyone? Nip this in the bud, learn from it...move on...and don't doubt yourself so harshly, that isn't a good habit to get into!

*Hugs* You did fine kiddo! Don't fret!

(this message was brought to you by someone that banged her head against the wall and cried non stop for making the slightest mistake in any protocol...till I learned to put things into perspective more....and that was a long road baby! LOL!)

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Specializes in ER, Research.

:wink2: You're awesome, TriageRN. I do feel better. I'm very hard on myself. I beat myself up b/c I set out cookies for patients and used my hands to transfer them to the serving dish, thinking "what if I scratched my nose?" I kicked myself for hours. It's just b/c I work w/ cancer pts who are immunocompromised most of the time. I have an infection phobia for these people. I guess nurses make lots of mistakes and most of them don't care. A mistake in my book is everyday practice for some, I've gotten a lot of strange looks when I explain my "screw-ups". Does expecting perfection ever end?:mad:

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Hey...I hear ya! But I would have you on my team anyday...even if you are a bit hard on yourself...LOL, I would knock that out of you in a few days..LOL! (remember..been there myself, not fun!).

YOu just keep being cautious and alert...just put it into perspective. In a perfect world all would work out...but hey, I did hear we don't live in one so I just do the best I can...a few mistakes sure, but I learn from them now!

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Specializes in ER, Research.

Oops, it did go through. My computer is acting whacky. :mad:

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Specializes in Infection Preventionist/ Occ Health.

You really shouldn't be tearing off the finger of your glove, because that negates the whole purpose of wearing them (but I'm sure you know that already!)

I probably would have gotten a new needle, but the patient's risk of infection is pretty low in this case.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

I see this practice done often..and as long as the finger is clean with approved cleanser...it is an okay practice vs not wearing gloves. I can't feel through my gloves..and I am the type of wierdo to take gloves home and try! I just can't feel..and was missing all the time!

Once I had direct skin contact..I did it! It is a nursing intervention that is up to the clinical judgement of the Nurse doing the treatment...I know I do no good to anyone unless I can actually hit the vein...and I do it clean, not sterile, clean (but close to as sterile as it can be considering I am a germ freak!).

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Specializes in Infection Preventionist/ Occ Health.
I see this practice done often..and as long as the finger is clean with approved cleanser...it is an okay practice vs not wearing gloves. I can't feel through my gloves..and I am the type of wierdo to take gloves home and try! I just can't feel..and was missing all the time!

Once I had direct skin contact..I did it! It is a nursing intervention that is up to the clinical judgement of the Nurse doing the treatment...I know I do no good to anyone unless I can actually hit the vein...and I do it clean, not sterile, clean (but close to as sterile as it can be considering I am a germ freak!).

I am not so much concerned for the patient as I am worried about the OP. She is putting herself at risk for an exposure, and it only takes once! I used to do phlebotomy with only one glove, but then I learned to palpate, glove, prep the site and stick without too many problems. It's harder that way, but it just takes practice. Also, I noticed that many phlebotomists wear gloves that are too large for them. I now wear the smallest gloves I can, and that helps a lot.

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Specializes in ER, Research.

That's definitely a bad habit that I developed in the ER, because we get a lot of peds, and don't want to stick twice b/c we can't feel. BSN, you're saying that the risk is to me and not the pt? I brushed it so lightly I wasn't even sure if I did touch it. In my mind I have this pt septic and dying already from a contamination, but I'm whacky. :rolleyes:

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