Feature: Ten Truths about Gloves
Gloves are an integral part of personal protective equipment for healthcare professionals assigned blood specimen collection responsibilities, and are a key component of every infection control program. But how much do you know about the quality and limitations of the gloves you wear? Do you inspect every pair that you don? Do you know the glove type that is most likely to leak? Do gloves have an expiration date? To test your knowledge, answer the true/false statements below:
This Month in Phlebotomy Today
Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 12th year of publication, are reading about this month:
For subscription rates and to subscribe to Phlebotomy Today, click here. The current month’s issue will be emailed to you immediately upon subscribing.
Q: I am looking for any study showing the use of cohesive bandages like Coban™ on patients on heparin or Coumadin. Have you ever seen a study or recommendation to support their use?
A: No, but their use makes good sense. Just make sure you and those who work with you and for you don’t consider such wraps as a substitute for applying pressure or observing the site prior to application.
Use it in conjunction with the practice of observing the site for hematoma formation for several seconds (5-10) after releasing pressure, but before applying the wrap. Too many folks are in such a hurry to bandage that they don't take time to observe for bleeding beneath the surface of the skin. To them, a wrap might be considered as a substitute for that step, and allow them to think that any bleeding will be absorbed by the wrap.
There should be a two-point check for bleeding: 1) look for bleeding from the puncture site and 2) check for hematoma formation. Failing to observe for a hematoma formation beneath the surface of the skin can cause serious complications, including nerve injury. In the CLSI venipuncture standard, this observation step is required for all patients, not just those on blood thinner.
Each month, PT-STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's website. For information on joining Phlebotomy Central, click here.
Last month, visitors to our website were asked what their facility's most important criterion is when selecting sharps safety devices for use in blood collection. Topping the list of responses at 48 percent was internal product evaluations. Next was staff preference, cited by 28 percent of respondents. Coming in a distant third was the price of the product (8%).
A comment supporting staff preference as the determining factor concluded that “if they do not like it, they won’t use it”. Although the cost of a sharps safety device should not be the only reason a product is selected, price and purchasing contracts may influence a facility’s decision, as indicated by the survey comments below.
One survey participant summed up their facility’s device selection criteria this way: A) That [the product] meets all current safety standards . B) That it meets the needs of all users (group evaluation by all users-staff preference). C) Pricing/inclusion in purchasing contract.”
For facilities subject to OSHA regulations, devices must be selected based on employee feedback (29 CFR 1910.1030(c)(1)(v)) and be evaluated for appropriateness for each procedure and effectiveness in preventing occupational exposures to blood and other potentially infectious materials. If the availability and variety of devices is restricted, the employer may be in violation of these requirements. According to OSHA, selecting a safer device based solely on the lowest cost is not appropriate. Selection must be based on employee feedback and device effectiveness.(1)
Facility types represented in last month’s survey include: hospital (76%); physician office laboratory (8%); public health department, academic/educational institution, health maintenance organization, and traveling health service (4% each).
This month’s survey question:
What Should We Do?
[Editor’s Note: This month, "What Would You Do?“ becomes "What Should We Do?". Instead of asking readers to offer solutions to our hypothetical scenarios, "What Should We Do?" gives you the opportunity to ask our team of technical experts for advice on your most pressing phlebotomy challenges. Whether technical or management in nature, we'll carefully consider solutions and suggestions based on the industry's best practices so that you and those in other facilities with the same problem can benefit, all the while maintaining your facility's anonymity. What Should We Do? is your opportunity to ask us for suggestions on the best way to handle your real-life dilemmas.]
What you don’t want to do is pinch, force, or manipulate in any way the collection device being discarded in order to make it fit through the opening of a sharps container.
As blood collection devices in use at your facility evolve, periodically assess the design of the sharps containers your facility is currently using in patients’ rooms. According to a study appearing in the December 2010 issue of American Journal of Infection Control, sharps containers have been associated with sharps injuries, and more than 90 percent of those injuries are related to container design. The authors of the study found that a sharps container with an enhanced aperture design can significantly lower such injuries. By converting to sharps containers with improved engineering the study group experienced a reduction in sharps exposures by up to 81 percent.(1)
Because no single container type meets the disposal containment needs for every facility, the National Institute for Occupational Safety and Health (NIOSH) provides guidance for selecting sharps disposal containers and evaluating their efficacy. In its document, Selecting, Evaluating and Using Sharps Disposal Containers, NIOSH establishes criteria and provides tools for evaluating the performance of sharps disposal containers.(2)
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