Trach suctioning without gloves??

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Specializes in Pediatric Oncology, Pediatric Neurology.

I've been a Peds nurse in the home health setting for a year now and the handful of times I've actually worked with other nurses in this setting, I've noticed they routinely suction (not in an emergent situation) without donning gloves. Is this normal in the home care setting?? I am a total germaphobe (I know, great career choice, right?), so I know I am a bit more cautious and follow infection control guidelines religiously by nature but it just seems a bit counterproductive to introduce bacteria into our already compromised patients airways, right?

Anyone care to shed some light on this situation?

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I've only ever done it in an emergent situation. Bad habit to develop.

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I (and all the other nurses) always wore gloves, however the patient's parents never did. It must have been ok, bc in the 20 years she has been at home on vent/trach, she has rarly been sick.

eta: that said, as nursing staff we should. It protects us and pt. i don't want to touch the suction tubing with my bare hands, for my own health. It is parent right/choice not too, as it is their home. It also may violate agency suctioning policy/procedure for staff not to wear gloves.

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The respiratory system is technically not a sterile environment sooooo... I mean, yea you should wear gloves but I don't think it's completely inappropriate. I wear gloves, my colleagues wear gloves. I've worked in home health where the family didn't though.

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Specializes in Pediatric Oncology, Pediatric Neurology.

Thanks for the replies! I found the CDC guideline that specifically addresses this issue although it is slightly unclear but does mention clean vs sterile gloves as an "unresolved issue". That being stated, nowhere in the text does it state "bare hands"...

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Specializes in Pediatric Oncology, Pediatric Neurology.
I (and all the other nurses) always wore gloves, however the patient's parents never did. It must have been ok, bc in the 20 years she has been at home on vent/trach, she has rarly been sick.

eta: that said, as nursing staff we should. It protects us and pt. i don't want to touch the suction tubing with my bare hands, for my own health. It is parent right/choice not too, as it is their home. It also may violate agency suctioning policy/procedure for staff not to wear gloves.

This says a lot about the agency I work for, I've asked for the policy and procedure from the Clinical Supervisors and there is not one to be found.

As far as the parents go, they all suction without gloves- they can do what they want including feeding large pieces of pepperoni pizza to my NPO pt who is also a silent aspirator requiring me to perform the Heimlich so donning gloves is the least of my concern as far as families go 😉

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Very interesting. I am a new grad and of course we were taught it is a sterile procedure. Clean gloves vs. Sterile may be up for debate but no gloves at all during routine non emergent suctioning? Hmm

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Specializes in Complex pedi to LTC/SA & now a manager.

In the home it's clean not aseptic/sterile. Just washed hands & clean non-sterile gloves for trach suctioning. For scheduled trach change clean technique using sterile drape, gloves, lubricant, kit.

Trach ties are not sterile

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I agree with JustBeachyNurse's comments. Although there are times when I don't as I'm more concerned about a rapid intervention. I have seen caregivers and family members skip gloves altogether or use just one glove.

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I think it depends.

I do not wear gloves when suctioning if using an in-line suction catheter on a vented pt.

If the catheters have sleeves,I might not use gloves.

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I wear gloves with inline suction and when I need to set up and suction someone without inline it is policy of my hospital to use sterile technique, I was taught that in school too. I'm sure in an emergent situation I wouldn't be going so crazy over having sterile technique, although I'd try my best, but its best to be safe!

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Specializes in Complex pedi to LTC/SA & now a manager.
I wear gloves with inline suction and when I need to set up and suction someone without inline it is policy of my hospital to use sterile technique, I was taught that in school too. I'm sure in an emergent situation I wouldn't be going so crazy over having sterile technique, although I'd try my best, but its best to be safe!

In home health/private duty nursing sterile technique is generally unrealistic. Most new grads would pass out when they realize clean technique and soap & water is often sufficient for intermittent bladder catheterization.

Inline gloves are recommended because good practice and because there is no guarantee that everything was suctioned off the end of the inline (ask me how I know. I had gloves on, removed the suction tubing to cap off the Ballard inline and had a nice big mucus ball waiting for me!) good hand hygiene is essential as there have been some nasty cultures when the flush port is left open or the inline is left uncapped and floating in the breeze. Even with a sleeved catheter gloves are recommended for non family/household as many the port must be closed with a (gloved) finger.

If I just tossed my gloves and a patient is plugging I will sanitize then suction (I've yet to run out of sanitizer in my pocket like I do gloves). Nasal suction without gloves is gross especially with Little Suckers with an open port!

In a hospital setting clean or sterile is necessary. In a home or classroom with a child, it's very different.

I wear gloves to change a soiled diaper (oddly not everyone does) partly because I can usually contain the diaper with my removed gloves. Mostly because I don't want the body fluids of others on my skin if I can help it

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