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valoriedunn
PIV

This has been bothering me for several days.  If we use "clean" gloves when we place a peripheral IV and stablize it with "sterile securement,:" how is the securement still sterile and would not using sterile gloves cause complications?  Just me analizing too deep into this? 

 Valorie Dunn, BSN, RN, CRNI

 

Random VAT person
I have thought that before

I have thought that before and been troubled also.

I picture it this way:  Since we do not have on full barrier, cap, gown, sterile gloves, full body drape, draftless room, etc.  It is not a surgical sterile procedure.  We are attemping an medical aseptic procedure as much as possible.  We are not to bring any extra organisms to the area.  (the patient has plenty or so I tell the new grads to keep them thinking) 

ie we wash hands and then glove.  (aseptic:  sterile, sanitized, or otherwise clean of infectious organisms)

for example:  Not washing/gel hands prior to putting on gloves would contaminate the outside of the gloves as your putting them on.   Then when you touch the patient you would be bringing organisms to the patient.  That would not be good aseptic technique. 

Even changing a CVC/PICC dressing is not done with sugical asepsis. 

There are two types of asepsis: medical and surgical asepsis. Medical or clean asepsis reduces the number of organisms and prevents their spread; surgical or sterile asepsis includes procedures to eliminate micro-organisms from an area and is practiced by surgical technologists and nurses in operating theaters and treatment areas. (wiki)

 

 

Like our ultrasound probe,  without a cover even with PIV sticks, we are exposing it to germs.  We now place a dot of gel then sterile/clean tegaderm, then use sterile gel only.  We use a larger clorahexidine scrub and scrub an oversize area of the arm for 2 minutes and allow to dry.  The clean tegaderm protects the probe and the patient. 

 

Does that help?  ramble, ramble, lol. :)

lynncrni
 The stabilization device

 The stabilization device would not be still sterile if not using sterile technique. I am also lost by your comments on sterile gloves causing complications?!?!. INS Standards and CDC Guidelines both state that if you are palpating the site after skin prepping, you should be using sterile gloves. We have a problem with infections from peripheral catheters that is just beginning to get attention. Claire Rikard from Australia has done the work on studies showing that changing PIV when clinicall indicated has virtually the same complicaiton rates as when changed at a specific 72 to 96 hours. She has a lot more studies in the works on PIVs. She spoke at AVA and was great. We have a lot to learn about insertion and care of PIVs! Lynn

 

 

 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

valoriedunn
Hi Lynn, I did not state that

Hi Lynn,

I did not state that properly.  I should have stated "wouldn't using clean gloves instead of sterile cause more complications"?  I never palpate the vein after preping the site.  The PIVs I do monthly are to infuse then remove so I have never had any complications but our hospital nurses "historically" get their tape ready by sticking it to the bed rail:(  That bothers me and got me thinking about using clean gloves touching sterile products and stabilization products then no longer being sterile. Thanks. 

Valorie Dunn, BSN, RN, CRNI

Valorie Dunn,BSN, RN, CRNI, PLNC

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