Peri-care without gloves?

Nurses General Nursing

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I just shadowed for a private in-home position for a quadriplegic gentleman to observe his morning routine.  I found it odd that the peri care (and in fact, all care) is being done without gloves.  The man himself is very cognizant and particular about all his care- he is the one who hires his own staff and is a strong self-advocate.  The caregiver I was shadowing simply said that gloves aren't used because there would be so many glove changes necessary, so instead the routine is to wash hands at different stages.  My impression was that this was not her idea, but rather she was instructed by the client to do it this way.  So, I'm curious to know if this is an appropriate/accepted technique in the larger community.  I've been taking caregiving positions for several years, with diverse clients, but this is a first for me.
 

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Specializes in Psych (25 years), Medical (15 years).

Yours is a very good question, lightning, and I'd be interested in reading others' responses.

This situation reminds me of one that I experienced as a NS for a HH agency. I was making a supervisory round, for the first time as a NS, to a paraplegic's home where he received skilled visits from an LPN. Another LPN, who was going for her RN, was following me as an assignment.

We learned that the HH client who cathed himself did not use a new urinary catheter each time he performed the procedure. He would rinse the catheter off and clean it with a bleach solution.

Having had only previous hospital experience as nurses, both the LPN who was following me and I had never heard of such a thing.

We later learned that this was an accepted HH practice.

I was considering your situation and believe that if I was caring for, say a loved one in my home, I would not necessarily wear gloves every time I provided hygienic measures.

Like I said- interesting question and I'm interested in others' viewpoints.

BTW: Welcome to allnurses!

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Back in the day we didn't have gloves for things like peri care. We folded wash cloths into mitts. It wasn't a big deal. We had soap and water. 

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Specializes in Psych (25 years), Medical (15 years).

I was thinking the same thing, Wuzzie.

I didn't start wearing gloves until 1984 when I first heard of AIDS.

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3 minutes ago, Davey Do said:

I was thinking the same thing, Wuzzie.

I didn't start wearing gloves until 1984 when I first heard of AIDS.

Even then we were told the gloves were "for the doctors". 

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Specializes in Psych (25 years), Medical (15 years).

Actually, I asked two paramedics why they were wearing gloves and that's where I first heard of AIDS.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I suppose in working a private position there may be some instances where clients prefer certain routines that seems unusual but become acceptable. I would imagine that if it is something that concerns the care provider, they could bring their own gloves, especially if it is an expense issue. But as has been pointed out, there are other methods to keeping the process generally sanitary for both parties. One of the main reasons for using gloves is to decrease infection rates when providing care for more than one person at a time. In a private duty position, only one person is being care for so there's no chance of transmission of an infection from one patient to another. So as long as proper hand hygiene is completed by the care provider it should be sanitary. 

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Specializes in Home health care.

I have a love hate relationship with gloves. One, with them on there is more chance of cross contamination and without them on you’re typically more diligent about washing them. Hot water and antibacterial soap is good and do it every stage or so and I don’t see an issue. ?

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I'll be odd man out: I would not provide professional/paid peri care without gloves for the same reason I wouldn't perform a basic/routine GU provider exam without gloves. I don't care who is paying for the services or about the fact that gloves do have some expense associated with them. I would not use gloves for basic skin care.

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9 hours ago, JKL33 said:

I'll be odd man out: I would not provide professional/paid peri care without gloves for the same reason I wouldn't perform a basic/routine GU provider exam without gloves. I don't care who is paying for the services or about the fact that gloves do have some expense associated with them. I would not use gloves for basic skin care.

Just to be clear. I use gloves now but not using them isn't that horrific. We don't glove when we take care of our children's elimination needs or our own. Soap and water suffices. I do prefer not to have someone elses poo on my hands though. 

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Specializes in Dialysis.
20 hours ago, Wuzzie said:

Back in the day we didn't have gloves for things like peri care. We folded wash cloths into mitts. It wasn't a big deal. We had soap and water. 

My mom said the exact same thing. And followed that up with things have changed, and many more funky diseases out there!

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Specializes in orthopedic/trauma, Informatics, diabetes.
On 1/5/2022 at 1:03 PM, Davey Do said:

He would rinse the catheter off and clean it with a bleach solution.

I believe this is acceptable for people that self cath, although, I hear that insurance is covering single use catheters now. 

I am so used to wearing gloves that I feel weird taking my sons' BG or giving them insulin w/o gloves LOL

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