Gloves Information and Courses from MediaLab, Inc.

The following items must be available at the collection site in order to conduct a proper collection: Collection kit. Proper custody and control form. Bluing agent to add to the toilet bowl or water tank to prevent a donor from diluting the specimen. Single use disposable gloves for use by collectors while handling specimens. If appropriate, proper signage to prevent entry into the collection area.

Procedural Step Comment Caution Greet and positively identify patient Always use at least two patient identifiers to ensure positive patient identification. Never rely on name placards that are placed on or near the patient's bed or crib to identify the patient. If there is a discrepancy in identification, do not proceed until the discrepancy is resolved. Explain the procedure If the patient is a small child, be at eye level when explaining the procedure. Also explain the procedure to the parent(s). If the patient is aware of what will be happening there is less chance of the patient suddenly jerking away his/her hand when the puncture occurs. Position patient appropriately An outpatient who is a small child should sit on the parent's lap. If necessary, seek assistance for finger puncture if the patient is a small child. Cleanse hands and put on gloves Use soap and water or alcohol-based gel to cleanse hands. Cleanse hands before donning gloves and after removing gloves. Warm puncture site if needed Use the method that is approved by the laboratory for prewarming the puncture site. Never use a moist cloth that has been heated in a microwave as this may cause injury to the patient. Gather appropriate equipment Only have needed equipment at hand. Keep track of ALL equipment to prevent patient injury. Cleanse the puncture site Use 70% isopropanol unless the patient is sensitive to alcohol. Allow the site to air dry. Performing the puncture before the alcohol has dried may hemolyze the blood specimen. Securely grasp and puncture finger Puncture the side edge of the fleshy pad of fingertip. Avoid extreme side and tip of finger. Discard puncture device into appropriate container Puncture device should be discarded into a sharps container that is puncture-proof, has rigid sides, and has a lid Do not discard puncture devices into regular trash or biohazard bags. Injury to personnel who handle these bags may occur. Wipe away the first drop of blood Use slight pressure to facilitate blood flow. The first drop of blood contains tissure fluid that may contaminate or dilute the blood specimen and affect test results. Collect blood into container Allow blood to flow freely into the collection device. Tap the container gently on a hard surface to move blood further down into the tube if necessary. Do not "milk" the finger or scrape the collection device across the finger to obtain specimen; both actions may cause the specimen to hemolyze. Mix specimen immediately upon completion of the collection. Apply pressure to the puncture site to stop the bleeding. Use gauze to apply pressure to the puncture site. It is not advisable to apply an adhesive bandage over the skin puncture site if the child is less than two years old as the child may place the bandage in his/her mouth. Label specimen Specimen must be labeled in the presence of the patient. Unlabeled specimens will be rejected by the laboratory.

It is important to remember that the collection of a specimen by dermal puncture may involve the potential of exposure to bloodborne pathogens as well as other safety considerations for both the phlebotomist and the patient. Some important safety reminders are listed in the table below. Safety Reminder Reason Comment Gloves are always necessary Blood contaminates the skin during a capillary blood collection. Gloves protect the phlebotomist from potential exposure to bloodborne pathogens. Gloves must remain intact to be an effective barrier against exposure to potential pathogens. Wear additional PPE, such as lab coat or gown when appropriate or required. Safety goggles and surgical mask may be needed if there is a potential for splashes or sprays of blood. May be needed to protect the phlebotomist or may be required to protect the patient from potential infection in some cases. Safety goggles and mask should both be worn to adequately protect the eyes and mucous membranes from exposure to bloodborne pathogens if there is the potential for splashes or sprays of blood. Only have the equipment needed for this procedure at hand and additional equipment out of reach of the patient. Protects the patient from accidental injury Often, capillary procedures are performed on very young children who are curious and may grab something that could cause injury.

In addition to the puncture device, additional equipment may be required when performing a successful dermal puncture.Plastic microcollection devices: Plastic microcollection devices are small plastic tubes designed to collect capillary blood from a dermal puncture wound. Each small collection tube is color-coded in the same manner as blood collection tubes used for venipuncture. The color of the cap of each container tube corresponds to the type of additive inside the tube, most often an anticoagulant. The additive coats the inside of the tube. Examples of microcollection devices are shown below. Heel warmer: It is best practice to warm the heel of an infant with a warming device known as a heel warmer. The heel warmer, when activated, is designed to warm its contents to a standardized temperature. This temperature will be hot enough to effectively warm the heel and facilitate blood flow to the area without causing heat injury to the patient. It is unacceptable to warm a cloth using a microwave. There may be "hot spots" on the cloth that could potentially burn the patient. Keep in mind, what may feel warm to you, the phlebotomist, may feel hot to your patient!Plastic or Mylar-wrapped capillary tube: In some facilities blood from a capillary puncture is collected directly into a capillary tube. These tubes are very delicate and must be used with great caution. As soon as the tube is two thirds to three-fourths filled, one end is sealed to prevent blood from leaking out.Glass microscope slides: In some facilities, the person collecting the capillary specimen may also be required to prepare a blood smear for laboratory examination. A drop of blood is placed directly on a glass slide and spread to create an area for cell examination. If you are required to prepare blood smears, remember that the slide is considered infectious until fixed or stained. It is also important to remember that glass is a sharps hazard. If not used correctly, the glass may cause injury to both the patient and the phlebotomist. Be as cautious with a glass slide containing blood as you are with a contaminated needle. Dispose of glass slides that will not be used for testing in approved sharps containers.Alcohol and gauze pads: Alcohol is the disinfectant of choice for dermal puncture. The alcohol must be allowed to air dry, which will prevent hemolysis of the specimen and discomfort for the patient. A piece of clean or sterile gauze is used to wipe away the first drop of blood. Gauze is also used to apply pressure to the wound after the specimen collection is complete to stop the wound from bleeding.Iodine or other approved cleaning agents may be used as an alternative to alcohol.Bandage: It may be necessary to apply a bandage to the puncture wound on a finger or heel if the site continues to bleed. However, it is NOT recommended to bandage the finger of a child who is 2-years-old or younger since the bandage may become a choking hazard if the child puts that finger in his/her mouth.Personal protective equipment (PPE): All healthcare professionals that may come in contact with blood and/or body fluids while performing a laboratory procedure are required to wear intact gloves. It is against safety guidelines to alter gloves in any way that may compromise the integrity of the gloves. Eye protection, such as safety goggles, is recommended if there is the possibility of a splash of blood while collecting a capillary blood specimen. In many facilities, special gowns are required in some patient areas such as special-care nurseries. Always follow the policies of your facility in regard to PPE.

Wear disposable latex gloves if available.Place a thick, clean compress (consisting of gauze or soft clean cloth) directly over the wound. The compress will absorb blood and help the clotting process.Apply pressure to the victim's wound by placing your palm directly over the compress and pressing firmly.If blood soaks through, do not remove the compress. Instead, add more cloth pads over it as needed. Removing the compress may reopen the wound and result in further bleeding.

Gloves must be worn: when there is a reasonable chance of exposure to blood, other infectious body fluids, mucous membranes, or nonintact skin. during vascular access procedures, including phlebotomy. when handling contaminated items or surfaces.Wear only flat rings under gloves as large rings may tear gloves.Replace gloves: Between patient contacts If they are damaged or contaminated Before leaving the work area. Wash hands after removing gloves.Never wash disposable gloves.

However limited or spacious the available area is, the establishment of a work process that directs the flow of both staff and specimens in a unidirectional flow is essential. Personnel should be educated to begin work in the "clean" area designated for reagent preparation; move on to the area designated for specimen preparation and extraction, and lastly, proceed to the area for amplification and detection.Back and forth movement between these areas in the course of one run of specimens should NOT occur. Each area should have the necessary dedicated equipment to allow for the segregation of activities to their designated areas. Examples include pipette devices, small tabletop centrifuges, water baths, and racks. Gloves should be removed and disposed of before proceeding from one area to the next.

C. difficile spores resist dessication for months and are known to persist on hard surfaces for up to five months. Spores persist even after exposure to air. Epidemic strain B1/NAP1/027 is known to hyper-sporulate, a virulence-associated characteristic of outbreak strains. Health care workers are important vectors for transmission, as they may carry the spores on their hands or clothing. Alcohol-based hand sanitizers are very effective against non-sporulating organisms but do not kill C. difficile spores or remove the organism from the hands. The CDC recommends thorough hand washing using soap and water for caregivers and family members alike.Patients with C. difficile infection (CDI) should be isolated to a single room with a bathroom or cohorted (roomed) together. Staff treating infected patients should use personal protective equipment (PPE), including at least gowns and gloves, and must wash hands after removing gloves. The use of gowns helps to prevent contamination of clothing. Surfaces should be decontaminated using a solution of 10% sodium hypochlorite (bleach), this is effective in reducing environmental contamination in hospital rooms. The CDC recommends the use of bleach for cleaning patient and staff rooms during outbreaks. Control strategies involving reinforcement of Infection control practices rather than drug restriction are more effective. These practices include:Proper education of staff members involved in care of CDI patientsBetter isolation compliance Use of glovesFrequent and thorough hand washingEnvironmental decontamination

Personal protective equipment includes items such as: Fluid-resistant gowns or lab coatsShoe coversApronsGlovesCapsMasksEye protection

Follow this order whenever you wash your hands: Remove and dispose of gloves. Wet hands. Use liquid soap (bacteria live in soap dishes). Wash for at least 15 seconds, cleaning all surfaces (including under fingernails). Don't touch faucets after washing (don't recontaminate your hands). Dry with paper towels. Turn off faucets with paper towels.

Work practice controls affect the transport of blood and other potentially infectious materials (OPIM).Proper personal protective equipment (PPE), including eye protection, gloves, and lab coats or aprons, must be used when handling blood specimens and OPIM.Spilled specimens must be cleaned up using proper PPE .

when there is a reasonable chance of exposure to blood, other infectious body fluids, mucous membranes, or nonintact skin. during vascular access procedures, including phlebotomy. when handling contaminated items or when touching contaminated surfaces.

To protect the worker from blood borne pathogens, either latex or a latex like product such as nitrile must be worn when handling specimens or other items possibly contaminated with blood.Utility gloves or heavy-duty rubber gloves are useful when cleaning up spills or when there is a risk of damage from equipment handling.

Personal Protective Equipment includes items such as: Gowns Shoe covers Aprons Gloves Caps Masks Eye protection

Utility gloves may be decontaminated and reused if their integrity has not been compromised.They should be inspected regularly, and must be replaced if damaged.Hands must be washed after removing any gloves.

If you are allergic to standard latex gloves, you will be provided with hypoallergenic gloves or alternative products such as glove liners at no cost to you.

Follow this order whenever you wash your hands: Remove and dispose of gloves. Wet hands. Use liquid soap (bacteria live in soap dishes). Wash for at least 10 seconds cleaning all surfaces (including under fingernails). Don't touch faucets after washing (Don't recontaminate your hands). Dry with paper towels. Turn off faucets with paper towels.

When using formaldehyde in any concentration, with the exception of placing specimens in single vials, you must wear:Protective clothing with material that is impervious to formaldehyde A face shield and chemical safety goggles Gloves If there is a risk of formaldehyde reaching the eyes, chemical safety goggles should be worn with a face shield.

When using formaldehyde in any concentration, with the exception of putting specimens in single vials, you must wear: A cover gown or apron A face shield or safety goggles Gloves This personal protective equipment is provided at no cost to you.

Information concerning the eye, skin, and respiratory protection required while using the chemical Any special ventilation that might be neededNote that appropriate gloves (nitrile or in some cases, rubber) should always be worn when working with a hazardous chemical. Safety goggles or other face protection should also be used when handling chemicals, especially when the procedure is not being conducted in a fume hood.

Personal protective equipment is an essential way to protect yourself from the dangers of chemicals. You'll find on the label or safety data sheet (SDS) exactly what kinds of clothing, gloves, and coverings you'll need to keep yourself safe. Also, the laboratory's chemical hygiene plan will include information about necessary personal protective equipment and engineering controls that will reduce your exposure to hazardous chemicals. At a minimum, chemical safety goggles and rubber or nitrile gloves (not necessarily utility gloves) are necessary parts of your personal protective equipment.

A phlebotomist at Memorial Hills Hospital entered the room of a 6 year old patient. The only test ordered was a CBC, so the phlebotomist decided to do a finger stick. After gathering proper supplies for the finger stick, the phlebotomist began the procedure by putting on gloves and wiping the tip and side of the patient's ring finger with alcohol. He positioned the safety lancet between the ball and the side of the finger and made a small incision. The child cried as the blood was collected.

Remove the needle from the holder if appropriate, and properly discard it in an approved sharps disposal container.Discard all waste and gloves in a red biohazardous waste container. Wash hands.

Treat all blood & body fluids as if they were infectious.Always wear gloves during vascular access procedures.

Posted signs should alert you to patient allergies. Some patients may be allergic to latex gloves or tourniquets, or to iodine.Avoid using latex in case of allergy. Latex allergies are fairly common, and can be severe. May health-care institutions have reduced the use of latex because of allergies, but complete elimination of latex in the hospital environment is difficult, since it is a component of many medical products.

An impermeable lab coat should be worn to protect clothing from blood & other body fluids. Gloves must be worn while drawing blood and during all other patient contact. Appropriate face masks must be worn during contact with patients in certain types of isolation. A sign posted on the patients door will indicate special protective equipment that may be required prior to entering a patient room.

Required Step Description Step #1 Wash your hands. Clean your hands with soap and water or gel cleanser. Step #2 Positively identify patient using unique identifiers. Ask the patient to state his/her first and last name; if the patient is unable to give you this information, ask the patient's caregiver to confirm the patient's name. A second unique identifier must also be used. Step #3 Special test requirements Determine if the test to be obtained has any special requirements. For example, should the patient be fasting? Is this a timed test? If any requirements are not met, consult with the caregiver to determine a course of action. Step #4 Prepare the patient Explain the procedure to the patient and obtain cooperation. Usually the patient will extend an arm. (This is a form of implied consent.) Position the arm for venipuncture; support the arm on a firm surface; the arm should be in a downward position. Step #5 Site determination The patient can make a fist, but should not pump the hand open and closed. Apply tourniquet Palpate the vein. Release the tourniquet and assemble appropriate equipment. Step #6 Aseptic technique Wear gloves that have not been altered in any way. Cleanse site with approved disinfectant. Allow the disinfectant to air-dry to avoid hemolysis of the specimen and discomfort to the patient. Step #7 Specimen collection Re-apply tourniquet about 3-4 inches above puncture site, insert needle, bevel-side up, at about a 30° angle, and collect specimens. Remove needle and immediately activate the safety device. Mix specimens by gentle inversion 5-10 times. Step #8 Patient care Apply direct pressure to stop bleeding at puncture site; do not have patient bend arm as this may cause a hematoma to form. After about 2 minutes, check the puncture site to verify that bleeding has stopped. Apply bandage if appropriate. Thank the patient for his/her cooperation. Step #9 Specimen labeling Label specimen(s) in the presence of the patient including all the information that is required by your facility. Check the labeled tubes a second time against the patient's wristband to verify labeling accuracy. A professional phlebotomist follows the procedure in the same way for every venipuncture. This ensures that none of the vital steps are omitted. The phlebotomist who is consistent in performance and who concentrates fully to obtain a quality specimen is an indispensable part of the healthcare team.

Safety precautions should be observed when handling seminal fluid. The following guidelines should be followed:If non-disposable items are used, soak contaminated items(e.g., hemocytometers and coverslips) in 70% alcohol or other appropriate decontaminate.All disposable items should be placed in a biohazard bag.Non-latex or powder-free latex disposable gloves must be worn and hands thoroughly washed when the examination is completed.Seminal fluids that are to be discarded should be placed in biohazard bags.

•Public health guidelines recommend that manipulation of samples for influenza testing be done inside a safety cabinet.If an employee has close contact with a patient with known or probable Influenza A 2009 H1N1 illness, an N95 respirator, as shown in the image below, should be worn, according to CDC guidelines. Note that if an N95 respirator is used, it must first be fit tested to ensure a complete seal around the mouth and nose.Laboratorians should always observe basic infection control procedures including equipment/counter top decontamination and Standard Precautions that include the use of engineering controls such as safety cabinets; personal protective equipment (PPE), such as gloves, fluid-resistant outer clothing, and respiratory protection; and work practice controls, such as frequent hand washing.

The laboratory director is responsible for the development of a risk-based infection control plan for the laboratory.The personnel are trained in methods that minimize the production of aerosols.The personal protective equipment that is specified in the infection control plan is used consistently. A respirator is used when performing procedures that can result in aerosolization outside a biological safety cabinet.Disposable gloves are worn for all laboratory procedures.