gloves on while handling units

[macarton]

We were sited in a state follow up ipost JC inspection for not wearing gloves when we got a unit of blood out of the refrigerator to issue to a nurse. We had taken our dirty gloves off before doing this. Does anyone know of any regulations requiring this or not requiring? Any help would be appreciated. Thanks Mary

[rravkin@aol.com]

Hey Mary,

I think that what you should be asking is if there are any studies showing that gloves are as dirty as hands. With the push for hand sanitation and so many studies done to support a definite need, what you are saying is that you feel that the gloves are more soiled (or equaly as soiled) than the hands. I wonder if this is true?? But in practice a gloved hand is always seen as less soiled than a bare hand so I would suggest just replacing soiled gloves with fresh ones prior to handling any blood products.

[SMW]

Does the nurse wear gloves when picking up and transporting the unit? I'm not familiar with your state regs but I don't remember ever seeing a regulation that specifically requires gloves to be worn when handling an intact unit of blood. On the other hand, I have seen local procedures that specify gloves are to be worn so in those cases if someone was not wearing gloves they would be non-compliant with their policies/procedures.

[macarton]

No nurses don't wear gloves when picking up blood. I think they couldn't find anything, so that's what we got gigged on.

[John C. Staley]

Any idea what the wearing of gloves while issuing a unit of blood is supposed to accomplish? Protect you? Protect the unit? Protect the patient? Protect the transporter? Was the inspector able to reference any regulation that they were making their decision on?

This ranks up there with the highest level of nonsense I've heard of recently and it takes quite a bit to even make the list anymore!!!!

:faq:

[Deny Morlino]

Wearing gloves in this scenario is not written into our procedure, however most nurses choose to wear gloves when transporting units to the floors. Better safe than sorry? I do not recall any regulation specific to this scenario.

[macarton]

Like I said, I think she wanted something to write up. She had an U of Alabama sticker on her name tag with their national championship. I had my Auburn lanyard on.

[L106]

Ooops! (Maybe it would be worthwhile to keep several buttons/pins/stickers from various universities, then whip out and slap on the appropriate one once you have had a moment to do a quick assessment of the inspector??? Just an idea.)

[macarton]

I wouldn't be caught dead wearing anything with Bama on it. Anyway we have to respond to this gig, and it need some reference. Thanks

[Eagle Eye]

We require gloves anytime handeling a unit of blood(at the bench everyone is required to wear gloves). Nurses do not wear gloves at the time of pick up(because they do not handle unit and BB tech places unit in a plastic bag before issue) but required to wear gloves at the time of transfusion.

[Liz]

We have elaborated on the CAP General Lab safety policy and yes the staff must wear gloves for their protection. The transporter or nurse wears one glove why? Well, the policy says she must carry the bag that holds the blood with the gloved hand while the ungloved hand is for pressing the lift button. Then on the floor... it goes on...

So gloves are worn all the time at the BB, at the bench etc.. And as there is often no time to remove the gloves we have labeled the PCs as biohazardous and the telephone etc..

It doesn’t upset anyone, it’s just funny. . We also have a dress code policy that is one page long! Also for safety…

Liz

[STDUFFY626]

Our SOP'S state that we observe universal precautions when handling all products and consider gloves as part of personal protective equipment (PPE). Is it possible that the inspector is citing you for something related to an sop statement or posted/approved work note and not necssarily a regulation?

[Liz]

Our SOP'S state that we observe universal precautions when handling all products and consider gloves as part of personal protective equipment (PPE). Is it possible that the inspector is citing you for something related to an sop statement or posted/approved work note and not necssarily a regulation?

Yes indeed, we observe the universal precautions and have the PPE all over the Dept. of Pathology and Lab Med. and this makes the CAP inspectors very pleased every 2 years . Frankly, it makes sense as we do want to go home in good health.

We also self- and cross-inspect ALL year long.

Liz :eek:

[Brenda K Hutson]

Unless everyone that follows an entire process through from the beginning to the end, also follows the same safety/hygeine standards, it is rather useless. For example, if the Donor Center staff are not wearing gloves when processing the units, then when they send them to us, we would probably want to wear gloves. But if we are not wearing gloves when we are processing the unit, then the transporter picking up the blood is at risk. And if the trasporter does not wear gloves, then the floor clerk or RN who might pick it up without gloves, is at risk....and round and round we go.

I have a friend who is a Microbiology Supervisor at another Hospital. He allowed his staff to "not" wear gloves, only for computer entry; that is until one of his Techs. got Shigella from a keyboard.

So, whether or not gloves are really "necessary" from a contamination point of view, for handling closed blood products, may be a debatable issue. But what should be emphasized is consistency from start to finish of the units themselves.

Just my thoughts....

Brenda Hutson, CLS(ASCP)SBB

[Joanne P. Scannell]

See what THEY have done to us!?

Ok, to get really crazy ... (and I do hope you don't take this too seriously!)

How many of you wear gloves while crossmatching? 1...2...3... yah, it's a regulation.

How many of you put the unit of blood on the bench when removing the segment while you are wearing these gloves because you are going to be performing the test? 1...2...3... yah, don't we all?

So, now isn't that unit of blood that was placed on the bench (considered a contaminated bench) now contaminated?

It goes back in the refrigerator to wait to be issued.

Then, miraculously, as it passes out of the blood bank, it becomes 'ok' as it hangs in the patient's room.

Does everyone who touches this unit wear gloves to protect themselves from this now contaminated unit of blood?

And how about in the OR ... this now contaminated unit of blood is being passed around in a sterile environment, contaminating the whole staff! Yikes!

Hmmm ... maybe we ought to wash the units down with antiseptic before we issue them ...

But then, then, has anyone done any testing to see what the effects are through the plastic? (a la label glue?)

I'm wondering how many people have died because we didn't wear gloves while issuing those millions of units of blood over the past 50 years or so.

How many of you wash your money before you touch it?

[Mary**]

:clap:Good for you JP!!

[adiescast]

Yuck! I would trust an intact unit of blood without gloves before I would trust money! We require gloves at any point that there might be exposed blood (removing a segment, starting a transfusion). We do put the blood in a bag for the transporter, so they never actually touch the blood unit, but if you want to go to extremes...if we touch the bag with our (possibly) contaminated gloves and they touch the bag with their bare hands...

But if they wear gloves to touch the bag and do not do the one hand thing described earlier, what happens when they touch the elevator buttons, open doors, etc.

I'm not sure you can cover all possible scenarios. Touching an intact blood bag is a bit different from using a keyboard in a testing area.

Edited July 26, 2010 by adiescast
wrong word

[mcgouc]

We have techs who rotate through different departments who won't touch a unit of blood without gloves. However, they leave their cell phones by their work stations in Micro and Hematology and talk and play on them while gloved. I realized this one day when a tech in Micro texted her friend who was in Blood Bank that day and the tech in BB picked up her phone and replied. I have asked them not to use their cell phones at the bench, but they say the lab safety manual does not address this issue. This thread reminded me of that problem. Is this issue addressed at most places?

[Malcolm Needs ☆]

Anyone caught using a personal cell 'phone in my laboratory has cells removed from their body, without the option of anaesthetic.

[DOGLOVER]

I don't know of any regs regarding this. We don't unless you happen to have gloves on. I usually take them off to issue because they may be dirty and the adhesive on the part of the tag that becomes a unit label sticks to the gloves. Never had an inspector (FDA,AABB, CAPor state) in either Mass or Florida say anything.

[BB1956]

I agree with JP. Enough is enough. These units of blood are the most tested thing in the lab. As long as they are sealed and intact---

[Candybar]

When we issue a unit of blood to a nurse who will then carry it to the floor, the unit is placed in a zip-lock bag. Then there is no reason for the nurse to wear gloves and if the unit were to be dropped and the bag break, it would be contained.