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Patients wear gloves for home infusion?

I am a new Home Infusion nurse and have a question about instructing the patient or family caregiver to wear gloves when administering their own (or family member's) medication or TPN and flushing the line. Of course, hand washing is first and I advise frequent hand washing or sanitizing, but I'm confused about the necessity for gloves.

I've seen different written and video examples - some advising and some omitting the wearing of gloves on patients and family, and even RNs. Also, our home infusion pharmacy seems to be running low on gloves, so has not been providing an adequate amount for the patients if they are, indeed, recommended.

I couldn't find any INS or other written standards about the topic.

Thank you!

macawake, MSN

Has 12 years experience.

1 hour ago, InfusionNewbie RN said:

I am a new Home Infusion nurse and have a question about instructing the patient or family caregiver to wear gloves when administering their own (or family member's) medication or TPN and flushing the line. Of course, hand washing is first and I advise frequent hand washing or sanitizing, but I'm confused about the necessity for gloves.

I've seen different written and video examples - some advising and some omitting the wearing of gloves on patients and family, and even RNs. Also, our home infusion pharmacy seems to be running low on gloves, so has not been providing an adequate amount for the patients if they are, indeed, recommended.

I couldn't find any INS or other written standards about the topic.

Thank you!

OK, I’m European and I don’t even know what INS is and don’t know what standards/policies you have. As a general rule though gloves, unless they’re sterile, are worn to protect the person wearing the gloves. Not the patient. Hands, with short non-fake nails and no rings, washed properly with warm water and soap and sanitized afterwards are likely a lot cleaner than a pair of non-sterile gloves taken out of a box that’s used multiple times.

I think what you need to do is find out your employer’s policy and whatever other relevant regulations there might be, so you know how to properly instruct your patients and their relatives.

I must admit that I’ve never heard of patients and relatives administering medications intravenously. I gather practices can differ quite a lot between countries? But if this is something they actually do, aren’t they given step-by-step written instructions to complement and help them remember your verbal teachings? I really would expect that your employer be able to supply the necessary information. I mean, in the absence of formal policies, then each individual client/patient could get very different advice depending on whatever information their individual nurse might have found on the internet. That doesn’t sound safe to me. I’m sorry I couldn’t be of more help.

Good luck!

Edited by macawake

jbudrick, MSN

Has 18 years experience. Specializes in Certified Wound, Ostomy & Continence Nurse.

I work as a Wound, Ostomy, Continence nuse in home care. I find that many patients erroneously believe gloves have some kind of magical property that prevents germs. Many don't even wash their hands before or after wound, IV, or ostomy care because they believe gloves alone are enough. I use these opportunities to provide education about gloves not replacing hand hygiene. In fact, hand hygiene is superior to only glove use when providing self care. Patients see medical professionals always wearing gloves during procedures. As nurses we need to remember that patients don't necessarily know about infection control. It is an important nursing function to provide basic infection control teaching to every patient - most importantly, hand hygiene.

NRSKarenRN, BSN, RN

Has 43 years experience. Specializes in Vents, Telemetry, Home Care, Home infusion.

Did home infusion for 10+ years ---

What is your infusion company's policy ---that's what you need to use to teach patients. Gloves were not routinely used by patients in the past unless chemotherapy being given or extremely neutropenic for performing IV flushes, hanging IVAB and TPN infusions.

Aseptic/Clean technique was taught for hand hygiene: wash hands, underneath fingernails with soap and water x 20 seconds or Use of alcohol based cleanser. Use needless connectors and prefilled syringes biggest way to decrease contamination. along with proper refrigeration of medications + clean supply storage by patients/caregivers. Now IV site care dressing change does require gloves -2 sets. PICC/Hickman/ Central lines should be performed by RNs using sterile technique.

With the current shortage of PPE, gloves should be used judiciously by home care patients.

Lehigh Valley Hospital, PA home infusion teaching is what I taught my home infusion clients:

Quote

Because your IV catheter and IV site need to remain as clean as possible, everything touching them must be sterile. This is why you must wash your hands for 15-30 seconds with soap and warm water before touching your PICC line or IV site.

It's equally important to wash your hands thoroughly afterward so you do not spread any potential infection to other people or other parts of your body.

Here are some additional tips for hand washing:

When to wash your hands:

  • Before and after touching intravenous tube or intravenous supplies
  • Before eating, drinking, handling or serving food
  • Before and after contact with sick people
  • After touching sheets, bandages, towels or any patient care item

How to wash your hands:

  • Use plenty of antibacterial soap.
  • Scrub between fingers, palms, back of hand and wrist.
  • Scrub for at least 10 seconds.
  • Clean under fingernails.
  • Rinse hands completely.
  • Use a clean towel to gently dry your hands.

https://www.lvhn.org/treatments/home-infusion-services/home-infusion-faq

INS = Infusion Nurses Society - develops standards for IV Infusion, education +scientific publications https://www.ins1.org/

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