Isn't it mandatory to use gloves when drawing blood?

As a nurse, I can tell you the gloves are for our protection more than your protection. I also work with children. When starting IV's or doing any type of needle stick, it is very, very difficult to feel the vein through a thick piece of rubber. And for those of you who are about to scream that they are made of latex, due to the increase in latex allergies, all of our gloves are now latex free and much thicker than they used to be. And these are not in any way, shape or form, sterile. Only clean.
That being said, yes, she should have washed her hands but I usually was my hands just prior to entering the room, then as soon as I'm finished. I also use the alcohol foam that is approved by the CDC, NIH and Joint Commission. It is perfectly acceptable to use the foam instead of washing . Lets say I walk into a patients room to ask if everythings okay...baically just to check on them. When I leave that room, it is legally okay for me to use the foam. Now if I've come into contact with body fluids, or they're visibley dirty, a good handwashing is in order. More than not, I wash with soap and water between my patients.
Why don't you just mention it to the nurse instead of taking to the higher ups? Just because you didn't witness a washing doesn't mean it wasn't done and I would rather it be brought to my attention so I could take care of any issues immediately, rather than not knowing you have an issue and it be a week or more before administration or supervisors get around to letting you know there is an issue. We're all grown ups and most of us are more than willing to do what is necessary to make the patient or their family feel more comfortable. Just my opinion though.
 
princess momma said:
Another thing is the privacy issue with the nurse drawing blood in the hallway! A huge no-no! In WI there must be a posted sign in the nursing home instructing you on how to contact the state to make complaints. If I were you I would contact the administrator or the director of nursing and they would most likely have to conduct an investigation.

But you do have to consider how your grandmother feels about it. Is she happy and safe there? It's her home and maybe she would rather you just let it go. She's had so much taken away from her and if you made a big issue out of it you could make her feel so much worse.
:confused3 Never heard about drawing blood being a privacy issue. Especially in a nursing home, and it looked like she said the nurse was doing a finger stick for a blood sugar? Even if done in the room, most doors are open. How would anyone know what the blood was being drawn for? For that matter, when I go to the hospital to have labs drawn for doctors appts, it's usually done in large room with 4 seats in it with multiple people having blood drawn at once. But this is the South, maybe it's different down here.
 
Lorix2 said:
I'm curious to know as the nurse drawing my grandmother's blood in her nursing home did not use a glove, nor did she wash her hands (in our presence anyway) before or after (in our presence).

When I was leaving and walking down the hall, another nurse was drawing blood from another patient in the hallway without gloves also. Both were doing a finger stick on my GM and the other patient.

This is in MA, so I don't know if it varies state to state, but it isn't sitting well with me for obvious reasons.

Thank you.

I am not sure what you mean by mandatory. Mandatory according to whom?
It is standard procedure, probably a policy at the facility and a good idea. I would say that the gloves are to protect the nurse and they are not sterile but they are "clean". A finger stick isn't a very messy procedure.
I wouldn't want to do it without gloves anyway.

I once had a nurse start an IV on me not wearing gloves. This was at a hospital and universal precautions were the standard. Oh my heavens, there was blood everywhere. Even a puddle by the bed. I was completely stunned. I did report it on the "Your opinion counts" mailer.
 
I am surprised to see these stories. :earseek: As a hospital nurse I can't believe there are people still doing this. Proper procedure is to sanitize hands (we use Purell) before and after gloves come off, and to wash hands if there is any soiling on the hands. We also use Purell before and after we enter patient's rooms to decrease germ transmission between patients. Violations of these policies are taken very seriously by administration. We actually have "spotters" who watch to make sure staff are doing this so you never know when you're being watched. ;) We also have an Infection Control team we meet with monthly to go over our unit's infection rate so that we can make improvements if we need to.

Maybe nursing homes aren't as strict as hospitals are, but they should be. There are all types of communicable diseases that can be transmitted between people when needles and blood are involoved. I've had many needlesticks myself, it's no fun waiting six months with worry while they run tests on you to see if you contracted anything. :worried:

Universal Precautions: http://www.ccohs.ca/oshanswers/prevention/ppe/universa.html
 
hugsquared said:
As a nurse, I can tell you the gloves are for our protection more than your protection. I also work with children. When starting IV's or doing any type of needle stick, it is very, very difficult to feel the vein through a thick piece of rubber. And for those of you who are about to scream that they are made of latex, due to the increase in latex allergies, all of our gloves are now latex free and much thicker than they used to be. And these are not in any way, shape or form, sterile. Only clean.
That being said, yes, she should have washed her hands but I usually was my hands just prior to entering the room, then as soon as I'm finished. I also use the alcohol foam that is approved by the CDC, NIH and Joint Commission. It is perfectly acceptable to use the foam instead of washing . Lets say I walk into a patients room to ask if everythings okay...baically just to check on them. When I leave that room, it is legally okay for me to use the foam. Now if I've come into contact with body fluids, or they're visibley dirty, a good handwashing is in order. More than not, I wash with soap and water between my patients.
Why don't you just mention it to the nurse instead of taking to the higher ups? Just because you didn't witness a washing doesn't mean it wasn't done and I would rather it be brought to my attention so I could take care of any issues immediately, rather than not knowing you have an issue and it be a week or more before administration or supervisors get around to letting you know there is an issue. We're all grown ups and most of us are more than willing to do what is necessary to make the patient or their family feel more comfortable. Just my opinion though.

As a nurse also, I totally agree with everything you wrote. Drawing blood is something a lot of nurses don't do, they didn't teach it in nursing school. Usually phlebotomists draw blood. Finding a vein on an elderly person can be very difficult to find. The best way to find a vein is by feeling not by sight. This is from experience. I have also noticed that a lot of older nurses do not use gloves. I find it icky, but some have worked 30 years without wearing gloves to draw blood. First, you should talk to the nurse and voice your concerns. By not talking to her you are making an assumption that she did not wash her hands prior or post to drwaing the blood. She could have before and after, you just didn't see it. I want to get rid of the needle first, and they must go into a special container, called a 'sharps' box. This is to prevent anyone from getting accidently stuck with the needle. She might have then washed her hands or used the antibacterial gel.
 
Lorix2 said:
I'm curious to know as the nurse drawing my grandmother's blood in her nursing home did not use a glove, nor did she wash her hands (in our presence anyway) before or after (in our presence).

When I was leaving and walking down the hall, another nurse was drawing blood from another patient in the hallway without gloves also. Both were doing a finger stick on my GM and the other patient.

Please, please PLEASE tell a nursing supervisor what you saw! This is a very sensitive subject for me, as we believe that this very exact thing is what caused the death of my son from sepsis. During a hospital admission, a nurse (brought from a different unit) started an IV without gloves, and without wiping the area with alcohol. I saw the whole thing, but I had become complacent because he had blood drawn a million times before and didn't say anything. Two days later he had a blood infection, one of those nasty hospital based ones that antibiotics can't fight off, and he died. The drs were stumped how he got the infection, because he went from doing good to deathly ill in hours. Of course we couldn't prove it, but other drs have even said that it very well could have been the cause. There are protocols for drawing blood for a reason, and some nurses just get lazy. We always make sure that we watch them wash and put on gloves, and twice since then we've had to remind them.
 
Lorix2 said:
I knew they should be wearing them and when I told my GM I was going to talk to someone, she got very upset and told me "not to cause trouble" because it simply would embarrass her but it's bothered me since saturday.

Whom should I call about it? Should it be enough to call the home or contact an agency that governs those things in which case, who is that? :confused3

I'm afraid if I called the supervisor of the home, they may not do anything about it.

I would call Your States Department of Health.

That is crazy that the person was not wearing gloves. How many people did she draw blood from before she came to your GM? She is putting herself at risk and than the Patients for not washing her hands.
 
Yes, I went to school for a medical assistant and I was taught how to draw blood and yes you are suppose to put gloves on right after you wash your hands and change gloves for every person you draw blood from.
 
When I got an IV for a MRI, the technician had trouble finding a vein so he called the Lead Nurse of the ER. She didn't wear gloves, and I bled a lot since she had trouble keeping the needle in the vein. She actually was wiping the blood off my arm with her bare hand. I wasn't too happy.
 
hugsquared said:
:confused3 Never heard about drawing blood being a privacy issue. Especially in a nursing home, and it looked like she said the nurse was doing a finger stick for a blood sugar? Even if done in the room, most doors are open. How would anyone know what the blood was being drawn for? For that matter, when I go to the hospital to have labs drawn for doctors appts, it's usually done in large room with 4 seats in it with multiple people having blood drawn at once. But this is the South, maybe it's different down here.


As a nurse I would never draw blood out in the hallway, whether it's for a lab test or for a blood sugar. There are federal regulations on privacy of medical information. I'm not allowed to discuss personal information with anybody but the patient, the patients medical power of attorney (if activated), and whomever the patient chooses I may share information (family members, friends, etc.). If I'm checking a blood sugar in a hallway, you could assume that person is diabetic and I'm giving out medical information to anybody who walks by. You may not be able to guess what the blood is being drawn for, but as a matter of privacy I do all procedures in a patients room, with the curtain pulled if more privacy is needed.

And you also need to consider things are different in a nursing home. A nursing home is a home for that person stuck in there. They have had everything taken away from them - many of their personal belongings, their independence, their choices. They need to be treated with respect and kindeness, not like a patient.
 
princess momma said:
As a nurse I would never draw blood out in the hallway, whether it's for a lab test or for a blood sugar. There are federal regulations on privacy of medical information. I'm not allowed to discuss personal information with anybody but the patient, the patients medical power of attorney (if activated), and whomever the patient chooses I may share information (family members, friends, etc.). If I'm checking a blood sugar in a hallway, you could assume that person is diabetic and I'm giving out medical information to anybody who walks by. You may not be able to guess what the blood is being drawn for, but as a matter of privacy I do all procedures in a patients room, with the curtain pulled if more privacy is needed.

And you also need to consider things are different in a nursing home. A nursing home is a home for that person stuck in there. They have had everything taken away from them - many of their personal belongings, their independence, their choices. They need to be treated with respect and kindeness, not like a patient.
Okay, okay...I wasn't giving you grief, we just don't do it that way where I'm at. And I've never worked in a nursing home...only acute care. But for people "assuming" why your taking a blood sugar or any other procedure, they can assume something just from your patient being out in the hallway. I give my patients a lot of respect and their privacy is part of that, but in the same instance, many patients don't mind and I always ask..."I need to xxxxx, do you want me to do it here or would you like to go back to your room?" I've never had anyone ask to go back to their room. Thats all I'm basing my opinion on. Did not mean to get you so riled up.
 
Hand hygiene (hand washing and use of alcohol hand disinfection) are very basic to Infection Control.
Wearing gloves for blood draws is also basic and has been around for a long time.
If they are not doing the basic things well, I'd be concerned about how well the less basic things are being done.
Sometimes staff get complacent about doing things like gloving in nursing homes because they know the residents and don't think of "picking up" any infections from them, but that doesn't mean it can't happen.

Standard Precautions (also called universal Precautions) are required by OSHA Law (Occupational Safety and Health Administration) care of all patients (whether in hospitals, Nursing Homes or clinics).
Gloves are required for all procedures that might involve exposure to blood or body fluids. That includes blood draws and the guidelines are pretty specific about that.
Note: Gloves are NOT necessarily required for injections (shots) because most times giving a shot doesn't involve any blood.

CDC (Center for Disease Control and Prevention) Guidelines and OSHA rules have required this since a set of guidelines for contact with blood and body fluids came out in 1991. (Bloodborne Pathogen Standard- 1910.1030)
"Standard" and "Guidelines" sound voluntary, but they are required. If a facility (Nursing Home, Hospital, Clinic) is caught not doing Standard Precautions, they can get cited by OSHA (BIG Fines) and/or by whatever state agency they are licensed by.

The gloves are primarily to protect the person who is drawing the blood and even though the gloves can be punctured by the needle, studies have shown that some blood is cleaned off of the needle as it goes thru the gloves. So, even if gloves are punctured, they do provide some protection. Sterile gloves are not necessary for blood draws - just clean gloves (which means the gloves are put on clean hands right before use. Gloves that are worn to run around and collect supplies or open cabinets are no longer clean).

Cleaning the skin before doing the blood stick is done to protect the patient from germs that might be on the skin.

Here's a page I got from searching on google for New Hampshire and Standard Precautions that summarizes the Guidelines:
http://www.ilpi.com/msds/osha/I19930201A.html

here's a link to the page specifically about gloves:
http://www.ilpi.com/msds/osha/I19930201A.html#gloves
 












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