We had a nurse report that she was issued a unit of blood by a tech and they hadn't removed or changed their gloves before retrieving, tagging and handing her the unit.  Now I know that the fridge handle, computer keyboard, and the outside of the unit bag are not "sterile" and the techs obviously wear gloves in the lab.  Aside from changing gloves to issue a unit (which of course still become contaminated by touching the aforementioned) what can be done to hand a "clean unit" to a nurse or courier?  We place the unit in a plastic bag but we're touching that too!  The whole thing is perception - isn't it?

Perception is important, but education can help smooth over the concerns. I think it's important to remember that the outside of the bag "lost it's shine" as soon as it left the shipping box and was used to collect blood. There is nothing sterile about a church hall, a high school gymnasium or any other of the myriad of places blood is collected. I wonder how hospitals reconcile the fact that "dirty" blood bags are transported into and used in their super-clean surgical suites ?

36 minutes ago, jnadeau said:

We had a nurse report that she was issued a unit of blood by a tech and they hadn't removed or changed their gloves before retrieving, tagging and handing her the unit.  Now I know that the fridge handle, computer keyboard, and the outside of the unit bag are not "sterile" and the techs obviously wear gloves in the lab.  Aside from changing gloves to issue a unit (which of course still become contaminated by touching the aforementioned) what can be done to hand a "clean unit" to a nurse or courier?  We place the unit in a plastic bag but we're touching that too!  The whole thing is perception - isn't it?

You could always irradiate the blood bag (as well as the blood), while the stupid nurse is holding it!!!

Do most institutions require a change of gloves with every issuance of blood? That's not part of our procedure.

Transport, no matter what staff, is supposed to be wearing personal protective equipment (gloves) when handling components . . .

3 minutes ago, David Saikin said:

Transport, no matter what staff, is supposed to be wearing personal protective equipment (gloves) when handling components . . .

They're handling the transport bag though David.  We don't have staff wearing gloves in public / visitor spaces (e.g. elevator).  It would look like they were in a contaminated area and forgot to take them off when they left.

1 hour ago, jnadeau said:

They're handling the transport bag though David.  We don't have staff wearing gloves in public / visitor spaces (e.g. elevator).  It would look like they were in a contaminated area and forgot to take them off when they left.

This is the perspective our institution follows.

On 5/26/2016 at 1:13 PM, goodchild said:

Do most institutions require a change of gloves with every issuance of blood? That's not part of our procedure.

Not part of ours either.

We do not change gloves to dispense blood components.

On 5/26/2016 at 5:10 PM, Malcolm Needs said:

You could always irradiate the blood bag (as well as the blood), while the stupid nurse is holding it!!!

Today my dear chap you win the internet! (again)

Thank you all for your confirmation of my take on this and Malcolm for giving us a laugh.  I guess what fueled me is the nurse's statement that the "lab techs needed to be properly trained ON infection control practices and she didn't feel it is her place to train this area of the hospital".  REALLY??!!  Emailed her explaining a little about microbiology and the need for her to concentrate on using sterile technique when spiking the bag and connecting to the patient's venous access.  Hope I've heard the end of this......if not it's radiation for her.

I think we are all missing the point.  I am guessing that the nurse has some idea of all of the yucky stuff we handle in the Lab.  And ALL hospital staff have it drummed into them to change gloves between patients and whenever gloves are soiled.  

Now, we in the Lab take this for granted, but how is a nurse coming into the Lab to know whether you are handling a unit of blood (or anything else that leaves the Lab for that matter) with clean gloves unless they see you change them.

"Cleanliness, in the absence of light, leaves nothing sterile" 

Scott

 

On 02/06/2016 at 0:39 PM, SMILLER said:

I think we are all missing the point.  I am guessing that the nurse has some idea of all of the yucky stuff we handle in the Lab.  And ALL hospital staff have it drummed into them to change gloves between patients and whenever gloves are soiled.  

Now, we in the Lab take this for granted, but how is a nurse coming into the Lab to know whether you are handling a unit of blood (or anything else that leaves the Lab for that matter) with clean gloves unless they see you change them.

"Cleanliness, in the absence of light, leaves nothing sterile" 

Scott

 

I see from where you are coming Scott, but what REALLY annoys me is people like this nurse who assume, with little or no evidence, that other people are not as well-trained in some areas (such as aseptic techniques), as they are themselves, and then make statements to this effect, as if it makes them feel superior.  In other words, people who think they know better than others how to do the other person's job, and assume that the other person has no idea how to do their own job, just because the nurse (in this case) did not see what had already gone on in the background.

As somebody said to me at a symposium this week, patients and doctors involved in a case with complex serology, only see a swan swimming serenely on top of the water when we produce compatible blood for transfusion, and don't see the feet working frantically under the water.  In the same way this nurse assumes she sees everything, but actually knows nothing.

I was only half joking about irradiating her!!!!!!!!

LOL Malcolm!  You seem to be assuming that this nurse "assumes she sees everything, but actually knows nothing"!

What a card!  Complaining about someone who assumes too much whilst assuming that that is what her motivation is!

After all, when we ASSUME, WE ARE ONLY MAKING A REALLY BAD AND OVER-WORKED PUN!

Scott

Oh no Scott, I am not assuming the nurse knows nothing (as someone has already said, she will have been trained in aseptic techniques herself - I hope!).

What I was saying was that the nurse appears to be assuming that, unless she has seen, with her own eyes, the staff within the laboratory using aseptic techniques, that the staff in the laboratory are either not trained in these techniques, or are not performing these techniques.

If it were me against whom she had made such comments, I would have been very insulted by her suggestion, albeit tacit, of unprofessionalism on my part.  I wonder how a surgeon would feel if a laboratory technician suggested that his/her aseptic technique was questionable, unless we had seen how they handle the units of blood in theatre?!

Edited June 6, 20169 yr by Malcolm Needs

If a surgeon touched anything that was not sterilized or in the sterile field, I would hope that not a few people working with him or her would say something!

 

Scott

25 minutes ago, Malcolm Needs said:

 

What I was saying was that the nurse appears to be assuming that, unless she has seen, with her own eyes, the staff within the laboratory using aseptic techniques, that the staff in the laboratory are either not trained in these techniques, or are not performing these techniques.

 

...and I just have to add that you seem to be assuming that the nurse appears to be assuming something about the Lab staff, which, I am assuming, you find objectionable.

 

Or rather, I assume that's what I you are assuming...

Scott

No Scott, I am not "assuming" that the nurse appeared to be "assuming", because jnadeau stated in the original post that the laboratory had been reported by this nurse.

3 hours ago, SMILLER said:

If a surgeon touched anything that was not sterilized or in the sterile field, I would hope that not a few people working with him or her would say something!

 

Scott

You mean like the non-sterile bag of blood being hung in theatre?

Perfusionists or surgical techs handle blood and other possibly yucky stuff.  If you see your surgeon touching anything that is not sterile, I suggest you get another surgeon!

Scott

16 hours ago, Malcolm Needs said:

No Scott, I am not "assuming" that the nurse appeared to be "assuming", because jnadeau stated in the original post that the laboratory had been reported by this nurse.

Sorry, I made another unjustified assumption there...

Scott

 

I'm so confused by this discourse.

Wow folks - didn't mean to start an assumption feud.  Has anybody ever seen O.R. staff in scrubs in the cafeteria? 

4 hours ago, jnadeau said:

Has anybody ever seen O.R. staff in scrubs in the cafeteria? 

All too frequently!

Yup -