Latex-safe policies, procedures should be a hospital-wide effort
Latex-safe policies, procedures should be a hospital-wide effort
Implementing a latex policy in the ED is most effective when it's a hospital-wide endeavor, says Susan McGann, RN, BSN, CEN, president of Delaware Valley Latex Allergy Support Network in Philadelphia, PA. "Education on latex allergy needs to be part of new-employee orientation and part of a mandatory inservice day once a year," she urges. "Clinicians hospital-wide need to be educated on protecting both themselves and their patients."
The entire hospital staff should be inserviced on latex allergy, stresses Donna Meehan, RN, BS, nurse manger of the step-down unit at Riddle Memorial Hospital in Media, PA. "This problem doesn't affect only the ED, it affects the entire hospital, which includes the dietary person who may bring in a tray of food with latex gloves," she says. "All departments in the hospital may interact with that patient at some point in time. Staff will always have questions, but they should at least know the basics."
As part of its latex policy, Riddle eliminated latex examination gloves throughout the hospital. "If you eliminate latex gloves across the board, you don't need special areas to isolate latex-allergic patients," says Meehan. "It really saved us that we eliminated so much powder in our institution so long ago. The only time latex gloves are in the hospital are from the kits that come with them-and right now we're in the process of eliminating those."
Paramedics should be encouraged to use low-protein powderless gloves or switch to non-latex gloves before entering the hospital, recommends Emilie Goudey, RN, BSN, CEN, a former ED staff nurse at Berkshire Medical Center in Pittsfield, MA. "Ideally, prehospital personnel should be wearing appropriate synthetic gloves, or at least powder-free latex," she says. "Even when hospitals have created latex-safe environments, the snapping off of latex gloves, particularly powdered, by prehospital personnel can continue to pose a hazard."
At Riddle, a "mini-kit" of latex-free supplies was created for the hospital's ambulances. "At first, EMS was really resistant to this, because, when they are dealing with a major trauma in the field, they are exposed to so much blood and bodily fluid, and they didn't want to switch from the heavy duty latex gloves they were using," Meehan reports. Recently, the hospital's EMS unit switched to latex-free gloves.
After a latex-free policy was implemented at St. Joseph Hospital's ED in Bellingham, WA, it was revised to include involvement of all hospital personnel. "We had all the nurses trained, but nobody bothered to train other departments, such as respiratory therapy and housekeeping, so we made it hospital-wide for everyone who has any sort of patient contact," says Janice Taylor, RN, CEN, a staff nurse in the ED.
The ultrasound technicians at St. Joseph's were told to ask patients if they were latex allergic before doing emergent ultrasounds, which have a latex condom over the probe. "We purchased boxes of latex-free condoms at a local drugstore and placed them in every ultrasound cubicle," says Taylor.
Hospital policy shouldn't be confined to employees-visitors should also be prevented from bringing latex into the hospital. At Primary Children's Medical Center in Salt Lake City, UT, latex balloons are banned. Family members who come to the ED with latex balloons are told about the policy, which requires the balloons to be immediately exchanged for non-latex.
"If we spot someone with a latex balloon, we immediately direct them to the gift shop or security, where they can exchange them for silver foil Mylar balloons free of charge," says Donna Ojanen Thomas, RN, MSN, CEN, director of the ED. "Sometimes people are very unhappy because they don't understand, but overall there is pretty good compliance." To educate visitors and the community, posters are hung which explain the policy, press releases were sent to gift shops discouraging visitors from buying latex balloons, and staff wear buttons that read "Mylar or Bust."
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