Use of Clean Exam Gloves

[BloodNGuts]

I am an OR nurse and have been recently advised by my management that it is no longer acceptable practice to wear clean exam gloves while transporting patients to and from surgery. Management has also advised the OR staff not to wear gloves while transporting the trash and dirty linen bags from the OR suite to the decontamination area. The theory concerning NOT wearing gloves is that if somone, ie., JCAHO, sees the gloves and does not know why the individual wearing the gloves is wearing them, the hospital might be sited. Infection Control is telling us that if the patient has a clean gown and clean linens on there is no need for gloves. This, of course, does not take into account splatter from IVs, etc while transporting. As a clinician with over 9 years of OR experience, I adamantly oppose this thinking. What is your experience? How does your institution view the use of clean exam gloves during transportation of patients?

Caryl Carver, RN, BSN

[Marie_LPN, RN, LPN, RN]

I'll always wear gloves handling the bags. You never know what the last person hand on THEIR hands/gloves when they touched those bags. Not to mention you never know when those bags are going to leak.

I dare a JCAHO clone to tell me to not handle the bags while gloved, I'll hand the bag directly TO them. Hey, if it's "clean" they should be fine with that, right?

I still wear gloves (a pair of clean exam gloves of course) , my mask and my eye shield when helping to transport a pt. from OR to PACU. I can't count how many times a pt. hacks a bloody loogy and launches it 3 ft. in front of them, and leaving a bloody mist everywhere else.

As for our IC, i have no idea what their stance is in this.

[gitterbug]

I remember when gloves were not necessary for a lot of patient care, then they became mandatory, now it changing back to not needed. Oh, yeah! Too funny for words but sad too. Cost cutting and penny pinching comes to mind.

[PeachPie]

I dare a JCAHO clone to tell me to not handle the bags while gloved, I'll hand the bag directly TO them. Hey, if it's "clean" they should be fine with that, right?

YES! I love putting backseat drivers to the wheel!

[ginger58, ASN, RN]

This is the biggest amount of crap I've heard today! What won't these people come up with next?? At least it doesn't involve more paperwork...

[Bluehair]

Our infection control personnel are still chanting the 'use protective equipment' mantra at every turn. You wouldn't catch me not wearing gloves for any of this stuff. Too many chances of contacting something you didn't know was there.....

[elizabeth321]

Write a formal complaint to your supervisors and send a copy to your union rep. for the reasons mentioned above.

People wear gloves when and if they want.....few things are done by ungloved hands.

Liz

[meandragonbrett]

Sounds like penny pinching to me. Request evidence that gloves aren't necessary.

[Crux1024]

Maybe also inform the Risk Management Department in your facility and see what they say. (If it wasnt them in the first place that told you to stop!)

[suzeeq]

Why can't JHACO ask why someone is wearing gloves? Surely it must be obvious by what they are doing!

[wilbur's mom]

Hi!

I think alot of us forget about the principle underlying the task. I teach infection control basics: PPE, is personal, to protect the individual, and nurse practice guidelines mandate that whenever there is the POSSIBLITY of exposure to blood or body fluids, we MUST wear the appropriate personal protective equipment, or be subject to serious LEGAL consequences, think OSHA and the Office of the Professions, (where our nurse license comes from). However, here is the rub, and where I think JACAHO and the State Health Depts. are coming from. PPE must be appropriate to the task at hand. #1 point, is that as soon as you put clean gloves on, they immediately become contaminated. But, they protect the wearer from exposure as they complete the current task, i.e. bagging biohazard waste. But recognizing clean to clean is clean, and clean to diry is dirty, and that we can never work from dirtier to something cleaner.......once you toss the bag into the cart.... you take your gloves off, WASH your hands, then push the handle of the cart, to where it needs to go, and don't therefore hit elevator buttons, or door handles, or touch a chart, with gloved hands that are more highly contaminated, (potentially infectious), or even smeared with unspeakables, when you move out into community areas. We get cited when we are seen to cross-contaminate. And it is up to each nurse to be able to identify to anyone who choses to ask, the reasons we are using the PPE our GOOD NURSING JUDGEMENT and LICENSURE requires us to use, and each circumstance might be different, but the rules don't change. And in a written Plan of Correction, like one I saw citing an aide who went from pericare to oral care to the hall linen cart to the next pt, and back again with the same contaminated gloves on and never washed hands, there are some serious reasons, like MRSA and VRE and C-diff why JCAHO deserves SOME credit! A big problem with chronic glove use is the reality that the line between tasks becomes blurred, and staff, in part due to our overwhelming workload and urgency of multi-tasking, forget, neglect, don't find time to, oops meant to, wash their hands and change their gloves. So, do not hesitate to state, I am wearing my gloves because, and yes, I washed my hands. The big reality is that handwashing studies prove that indeed, nurses wash their hands more than everybody else, but who is seen by our patients and residents, and family members the most? We are, so we are held to higher scrutiny and I believe, higher standards. And I am proud of that. I wash my hands often and publicly, and my students joke they would rather die than be seen by me to be wearing two gloves in the hall. Do they wear gloves in the hall to bag the linen? Of course they do, but that is critical thinking, and another lesson in itself. Sue.

[gitterbug]

Thanks so much for the re-education on this issue. I found it informative, useful and very important.