Ask the expert: Gloves and blood draws

By: January 27th, 2011 Email This Post Print This Post

Q: Does OSHA mandate that disposable gloves are required for blood draws? If so, where is the reference?

A: Gloves are required for employees doing blood draws.

The applicable section of the Bloodborne Pathogens standard is:

1910.1030(d)(3)(ix) Gloves shall be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous membranes, and non-intact skin; when performing vascular access procedures except as specified in paragraph (d)(3)(ix)(D); and when handling or touching contaminated items or surfaces.

Get into compliance with HCPro’s Basic OSHA Compliance Manual Kits for medical or dental practices. Receive bimonthly electronic manual updates through your newsletter subscription that keep your regulatory manual up to date and in compliance!

Comments

Gloves, once used, are they considered infectious and thrown in the bio-hazard cans or regular trash?

By David LaHoda on January 27th, 2011 at 11:25 am

Dispose in regular trash unless visibly contaminated.

Some lab staff feel it is acceptable to wear one glove, claiming to not be able to palpate the vein with a glove on. I do not see this referenced in the OSHA standard, what are your thoughts?

I too would like to know the stance on wearing just one glove during blood draws as it is difficult to palpate with both gloves on. Please advise.

This is also a hot topic where I work (wearing only one glove during blood draws). I am interested in your comments.

By David LaHoda on February 1st, 2011 at 11:06 am

Here are two perspectives, and both ultimately lead to wearing two gloves when drawing blood.

First, from an OSHA perspective—remember we are talking government regulators here—the burden of proof would be on you, the employer, to prove that wearing only one glove is a medical necessity.

Since lab staff in other facilities—and in your own apparently, since you qualified the scenario with “Some lab staff feel it is acceptable to wear one glove…”—are able to accomplish the procedure wearing two gloves, that might be difficult to prove.

OSHA would wonder whether your one-gloved-blood-drawing-lab-staff are insufficiently trained to palpate the vein wearing gloves. If so, you must document that additional training with the use of PPE was not able to overcome this problem, and that are there no other changes in work practices (see below), administrative or engineering controls that still allow a patient-safe procedure while providing maximum protection by wearing two gloves.

That’s a lot of training and documenting to accommodate “Some lab staff” who claim they cannot wear, or choose not to wear two gloves when drawing blood.

The second perspective suggested by a phlebotomy educator, who I consulted, points to the CLSI venipuncture standard (H3-A6), which states that gloves must be donned before the venipuncture is performed.

As the educator explained:

“This allows collectors to survey the intended puncture site and palpate the area to the extent necessary prior to donning gloves. The collector can identify the patient, assemble supplies, position the patient, apply the tourniquet and select the venipuncture site and vein, prior to putting on gloves. After the gloves are donned, the phlebotomist cleanses the intended puncture site, allows it to dry, and performs the venipuncture. Since this sequence in the standards allows for vein palpation before gloves are donned, there’s no legitimate excuse for drawing blood without wearing two intact gloves.”

The exception for this procedure would be for patients under isolation precautions, in which case gloves would have to be donned before palpation.

By FIONA MACLEAN on May 13th, 2011 at 2:28 pm

I FAIL TO UNDERSTAND WHY OTHERS HAVE TO WEAR GLOVES WHEN IN CONTACT WITH BLOOD AND NOT DEPARTMENTS WHO ARE TAKING A LARGE VOLUME OF BLOOD. WHAT IS THE DIFFERENCE. OSHA HAVE TO REVISIT THIS STATEMENT

I am concerned by the number of phlebotomists that palpate the skin after the intended puncture site has been cleaned. This is not how I was taught and would be a possible source of contamination. Two gloves should always be worn based on the OSHA recommendation. Personal pet peeve—why would one place a cotton ball that was laying on the pad/table be placed on the puncture site post draw? Yuck! Who cares if it looks clean—once it sits on an unclean surface it is not clean anymore. Also please discourage the practice of the individuals doing IM injections placing half the bandaid on their own skin. This is common at a local peds office.

By Carol Hutchinson on January 13th, 2012 at 11:57 am

I expect my staff in the laboratory to wear gloves, disposable lab jackets and eye protection (goggles or safety glasses). Our phlebotomists only wear gloves as PPE. I have always thought the phlebotomists should wear the same as the lab as they are as likely to be exposed to blood as the lab staff. I have seen needles pop off syringes, vacutainer tubes burst or break and spills with blood. It happens rarely, but it would only take one incident to cause harm. I have checked with other hospitals, clinics and labs but do not see them wearing anything but gloves. Any comments or recommendations?

I had a blood draw today and complained to the phlebotomist because she touched my puncture site *after* she had swabbed it. She became irate and impolite, declaring that the risk was only to her, not to me.

In the first place if in fact the OSHA standard mandates “gloves” that means two gloves, so she is blowing off the requirement. Secondly the statement that the risk is only to her strikes me as some sort of groupthink myth, impossible to really prove one way or the other. It sounds like the kind of thing people repeat often enough to that they end up believing that it is based upon some scientific proof. Is there any such proof, that the risk is only to the blood drawer?

IF OSHA CAME INTO YOUR LAB DEPT & YOUR PHLEBOTOMIST WAS NOT WEARING GLOVES TO DRAW A PATIENT; WOULD THE EMPLOYER OR EMPLOYEE BE FINED? WHAT IS THE FINE FOR SUCH ACTS?

A cowork of mine is renewing his CMA license and there is a question on the test that ask Who is not required to wear gloves while drawing blood? the options to pick from is Nurse, Doctor, phlebotomy instructor or blood donor phlebtomist. He picked doctor/phlebotomy instructor

All you people who think its so damn important deserve to get stuck multiple times. Try taking blood yourself for a few weeks.

Yes! Finally something about castle clash hack.

Just had blood drawn today and the girl wore NO GLOVES!!! Not even one!!! She had just drawn from another patient and didn’t wash her hands in between, and used the dirty cotton ball as described above.

I did draw blood for years, often 20- 40/ day. I ALWAYS wore gloves with the fingers intact. In the last five years I have witnessed several RNs and LPNs rip the index finger off of glove. Never saw a phlobotomist or Dr. Do this. It is a testament to a nurses ignorance and complacency when they do this. Don’t allow it if you are a patient.

By Gail Nixon on August 29th, 2017 at 1:27 am

Lab tech in op hospital lab put on gloves and went to opposite side of the room to reach into a high cabinet supporting herself with the other had on a counter to reach the kind of tube need. When she returned with the tube she needed I asked her “are your gloves okay?”. She said that area is sterilized after every patient. I learned later after thinking about it more that the counter which she later informs me stores the urine samples and blood products (!)in reality only gets wiped down once a day! Big meeting tomorrow at the hospital regarding this event. I left taking off the guaze bandage as I was concerned it was dirty and went back to ask her to reglove a clean one and redo it. The lab tech never told me to wash my arm but when I went directly home about an hour drive I washed the arm apart from the bandage with Hibiclens. Looking back I should have thought of soap and water but with open wound would not have wanted to do that in public restroom. Now I am concerned not for me but my clients. What are the top 3 or top 10 things I could pass on to others? Can I shake hands in church or at work or hug grandchildren safe from germ colonization. …. Scared in the buurrrgh!

By Tonya Collins on October 3rd, 2017 at 10:22 am

I went to get blood drawn for labs. The phlebotomist opened the door and called my name while I sat in the waiting room. She was already wearing gloves! We go back in tiny room and she was clearly intending to do the process with same gloves, which had touched the doorknob and for all I know she used for last patient. I said would you please wash your hands. She got huffy and said why, is it me? I said not personal but standard practice is to wash hands between patients and put on gloves. She rudely said you want me to wash my hands AGAIN?? I said yes, as you have touched the doorknob and I don’t know what else. I said unless you have just washed your hands, whatever is on your hands goes on the outside of your gloves, and then on my skin and possibly into my bloodstream. I just had neck surgery. She then took a very quick swipe at the site and I said would you please rub for 30 seconds and let dry for 30 seconds which is standard practice, or even 15 seconds? She got huffy again. I said why are you offended, this is not personal and is standard practice and this is my body and my risk of infection and I just had neurosurgery on my cervical vertebrae still healing. I told her if you don’t wash your hands, your gloves will be contaminated and even the gauze you grab for my site will be touched by your dirty gloves She was so rude. I was so shocked. Are all phlebotomists so touchy? What about MY life and safety?? Disgusting. Retrain them for standard practice! I am an RN and so disgusted right now.

By Tonya Collins on October 3rd, 2017 at 10:25 am

She did huffily wash her hands and put on fresh gloves but then she proceeded to open drawers and pull out her equipment with those gloves, rather than have it all set out first. WTH is wrong – can you not do SIMPLE STANDARD PROCEDURE WITH GOOD HYGIENE ON AN INVASIVE procedure in MY BODY!!!!!

Where can I find out if nurses have to change gloves between patients when giving TST or PPD (hundreds). Thank you

By Tracy Chenard on July 10th, 2018 at 12:34 pm

I went in to have my blood drawn yesterday and for the 2nd time the worker had a rip in her glove. The first time (Different person than the 2nd) both lab techs told me “we were taught to do that so its easier to find a vein” I reported her to the woman runs the lab..the 2nd im waiting for the lab to call me back. The lab is in a hospital and my insurance wont cover a different lab. The lab knows better but continues this practice, once is an oversight, 2nd is a dirty lab. Help!

After washing your hands, palpating, cleaning the area, prep. your supplies, could you use “sterile” gloves (the ones that are packaged) and re-palpate or would this still not be recommended for hard sticks?

Have you people never heard of bacteria? How about mrsa? Seriously, you are touching a site with an open wound and depositing germs all over it (because why would you wash your hands fiirst? They never do!) and say the risk is only to the phlebotamist?! Wash your hands and learn to do the procedure with 2 gloves! Also your table with the gauze/cotton sitting on it is dirty! Clean it. I’m so continually grossed out. Please osha, do something, this happens Everywhere I go ☹️😫

I donate plasma at a pretty big plasma center. I noticed the phlebotomists do not change their gloves often. Not after sticking a patient. Not after cleaning a chair. Not after taking a needle from a patients arm. I actually watched a phlebotomists take a needle out and clean up the client and used equipment. Then I watched her spray cleaning alcohol on the chair and wipe it down. Then she came and set up my plasma donation and stuck my needle in for the plasma donation. She never once changed her gloves. It’s all of the phlebotomists. Is this not against OSHA? I feel like they are increasing our risks of infections and although we are supposed to be clear of AIDS/HIV and other STDs there are slip ups and I’m sure people have come here with the viruses.

 

Leave a Comment

*

« | Home | »

Subscribe - Get blog updates via e-mail

  • test
  • HCPro Broadcast Events Calendar

hcpro.com