PPE dry intact skin

Anna Flaxis, BSN, RN · Jun 7, 2012

Unless the LOL had blood and/or other body fluids such as semen or lady partsl secretions all over her legs when you grabbed them, the tech was being a little over paranoid.

iluvivt, BSN, RN · Jun 7, 2012

Just an FYI....The term is actually standard precautions..it was changed many years ago. Yes... perhaps a little overly cautious...BUT..I cannot tell you how many times I have reached for a patient after checking for body fluids and there was something on their skin that I missed. For me it's usually blood on the underside of the arm..or something in the linens. So overall it is not bad advice because those little suprises are not fun.

Hey guys, quick question. Today in clinical (on a medical unit) I saw an elderly confused s/p CVA pt in a crazy awkward hanging out of bed position- I went right in to check on her because it did NOT look comfortable (she's not my pt so I don't really know her situation) and realized I needed someone to help me get her feet back in bed. Found a tech, asked for help, she followed me in. I gelled in, told the lady what we were doing, grabbed her legs/ankles and got her situated. when we walked out, the tech was all over me for not having put gloves on (in a well meaning way). She said something about they have a lot of hep C and HIV pts come through and all it takes is one cut on your hand and you're done yadda yadda... I am all for universal precautions, don't get me wrong! But I was under the impression that I dont need gloves to touch the clean/dry/intact skin on a patient who is not on precaution... I thought thats what all the gel and handwashing was for! Am I being too careless or was the tech being a little over paranoid? Just wanted to ask here...thanks a lot!

minnymi · Jun 7, 2012

err...i must admit that whether or not i wear gloves depends on the patient and situation. MEANING if it's a patient that has 50 tissues lying all over the bed that they've been hacking mucus on then i'll put some gloves on. i've had patients try to hand me spit rags and nasty things when i didn't have gloves on and i would just kick the trashcan over, say "hang on" and grab some gloves, or grab a papertowel and take it inside the clean towel. one nurse told me she always wore gloves every time she went into a room because of things like that. one time she went into a room and a patient asked her to hand them their drink. she picked it up and there was mucus all over the cup....stuck her hand right in it.

it's not a requirement and to me i'd rather take my chances knowing that i don't have open wounds on my hands than to have to put on gloves every other 30 seconds. there's only been once or twice that i've come into contact with an "unknown substance" (not blood) and i just wash my hands with soap and water and move on. one time it turned out to be jello.

i did have a co-worker stop me when i was going into the room of a patient with HIV and tell me i needed gloves on. i put some on because her making the comment made me second guess if i needed to wear them or not. i was just going in to take her temperature. i was right...you don't have to have gloves for that. her theory was "you never know" but like i said i'll take my chances unless i'm sticking somebody or something of that nature. do what makes you comfortable.

Anna Flaxis, BSN, RN · Jun 7, 2012

Just want to add that my post was in reference to HIV and HCV. Any time you anticipate contact with body fluids that aren't your own, PPE is appropriate. It doesn't sound to me like that was the case here. Of course, I'm sure you gelled or washed your hands after.

willtsmith · Jun 7, 2012

I do understand where you are coming from, but it is always a good idea to put gloves on when touching a patient as you may not know what is on their skin. Or while helping them, something else may come up that can expose you to the risk of contamination. So always make it a practice to clean hands, put gloves on and off, then clean hands again.

minnymi · Jun 7, 2012

as you can see, there is a difference of opinions.

the "correct answer" i think would be...follow the acceptable standard of practice. gloves are not REQUIRED just to touch a patient. if/when they are required then definitely use them. otherwise, it's whatever makes YOU comfortable and not what anyone else thinks. i ALWAYS put on gloves when anticipating coming into contact with blood/fluids. otherwise, i don't have time to put on gloves for every little thing and i don't "make time" because it's not something that concerns me. if it does concern you then do it. you weren't wrong today though. you were working with someone who does things a different way and thinks it's the only way.

caliotter3 · Jun 7, 2012

I have found that the time I don't put gloves on is the time that I put my hand into a gob of mucus. If I know of the patient, I am more likely not to wear gloves all the time, but if this is the first time I have seen them, I will most likely don gloves before touching their skin. Yet, I still manage to put my hands into gobs of this or that.

Pneumothorax, BSN, RN · Jun 7, 2012

I don't mean this in a mean way but patients can be gross-- in the sense that when they are sick bodily fluids get in places we don't expect, or they bleed or wipe their snotty booger on themself / bed sheet.

So ya- wear gloves wash hands :) stay clean and safe hehe

Anna Flaxis, BSN, RN · Jun 7, 2012

I guess I'm of the school of thought that donning gloves just to touch a patient when no body fluids or symptoms of infection are present can be alienating for the patient. Touch is such an important part of providing care and comfort that I will not put gloves on as a barrier between me and my patient if they are not indicated. If I happen upon a "surprise", it's no big deal to stop, wash my hands, and then apply appropriate PPE.

nurse2033, MSN, RN · Jun 7, 2012

You were correct. CDC says you wear gloves if there is a chance of contact with bodily fluids. That of course, is open to lot of interpretation. It does not mean to wear gloves every time you touch a patient. You were there and judged the risks.

trauma_lama, BSN · Jun 8, 2012

Thanks a lot for all your input, guys! Just wanted to make sure I'm not runnin' around the hospital actin' a fool... ;-)