Act now to make your ED latex safe
Act now to make your ED latex safe
In response to increased awareness of latex allergy, many ED nurses are taking an aggressive approach to making their facilities latex-safe.
ED nurses should take the lead in protecting latex-allergic staff and patients, urges Lori Warner, RN, BSN, a hospice case manager at St. Francis Hospital and Health Center in Beech Grove, IN, and a former ED nurse clinician who left clinical practice because of her latex allergy. "The time to act is now-don't wait for a committee or task force to be formed."
It's a mistake to wait until tragedy strikes, Warner stresses. "You never know when a co-worker or patient could have an anaphylactic reaction or complications from a latex allergy, and you could be the nurse caring for them," she says. "The time you spend developing a policy is nothing compared to the life you will save."
When Warner and another ED clinician developed latex allergy, they set out to protect themselves and patients. "We realized that our ED didn't have a policy in place or equipment readily available to care for latex-allergic patients, so we started to research and write a policy ourselves," says Warner.
Three isolation rooms with negative airflow were set aside for latex allergic patients. "The idea is to take the patient farthest away from other patient care areas," Warner explains. "If we know a latex-allergic patient is coming, we close the door and get the ventilation circuit going."
A latex-free box of supplies is used.1 "This way, staff doesn't have to panic and wonder if it's safe to use something on a patient or not-they know everything in this box is safe," says Warner. The box includes a sign for staff to hang outside the patient's room, alerting others not to wear latex gloves or allow any latex items to come in contact with the patient.
The latex procedures enable staff to safely treat patients without delay, such as when a child with spina bifida had a severe reaction from a drinking straw containing latex. "The staff knew right away how to treat her, which was comforting to her mother who was very well-informed about latex allergy," Warner recalls.
At St. Joseph Hospital in Bellingham, WA, a "latex-task force" was created to develop a policy on latex allergy, conduct hospital-wide inservicing, and create a latex-free cart. (See list of the cart's contents in the chart on page 68.) "This wasn't in response to any particular incident-we wanted to act before a serious problem occurred, " says Janice Taylor, RN, CEN, a staff nurse in the ED. "We're a small community hospital, so we expected to use the latex-free cart three or four times a year. We were shocked when, during the first six months, we used it over 15 times."
The ED is beginning to standardize its supplies and use mostly latex-free products. "Most of our IV tubing and all of our airway boxes are latex-free now," says Taylor. "As more of our equipment is getting to be latex-free, one of these days the latex-free cart will become obsolete, because the whole hospital will be latex-safe."
The hospital also switched to powder-free latex exam gloves and streamlined its glove-buying process. "Before the policy, we were buying over 80 different gloves. We switched to a single exam glove, which saves time, money and confusion," says Monica Grimes, RN, BSN, an occupational health nurse at St. Joseph.
"If anyone has problems with latex gloves, we give them a vinyl glove, and if there is any problem with that, a nitrile glove," says Grimes. The number of employees who reported problems with irritation from latex gloves dropped from 46 to 32 on an annual basis as a result of the latex policy, she reports.
At United Hospital in St. Paul, MN, a latex allergy clinical nurse specialist role was created to protect patients and staff. Latex-allergic patients are particularly vulnerable in the ED, says Kristi Miller, RNC, MS, CNS, the hospital's latex allergy consultant and project manager. "Quick action is required, and the patient may not be alert or able to speak," she notes. "Also, they are sometimes in a large area with only curtains to divide them from other areas where latex may be used, and there is usually high glove use, especially during a code."
Since it's impossible to identify all ED patients who are latex allergic, it's better to err on the side of caution, says Miller. At United's ED, many products have been standardized to non-latex, such as code supplies, IV tubing, and invasive items. "Product changes to non-latex give the staff time to treat first and ask questions second," says Miller.
ED nurses need to be leaders in their hospital when it comes to latex allergy, Miller stresses. "ED nurses are front-line people who notice symptoms and risk factors that can be communicated to the admitting floor," she notes.
Acting to protect patients can save lives, says Miller. "The patient with latex anaphylaxis often has severe laryngeal edema and needs to be intubated quickly, or you may not be able to establish an airway," she notes. "Nurses need to know that a latex allergic patient may not be able to have successful resuscitation with latex ET tubes, IV tubing, or Ambu-bags."
Failing to protect latex-allergic patients is not only bad patient care, it's also a possible legal risk, says Warner. "The information is out there, so if you're not doing what you can to protect patients, I think you're setting yourself up for a liability," she notes. "If you don't know how to treat them, you are putting them at risk from the minute they walk in your facility. They could potentially have a reaction just from walking in the door."
Reference
1. Coulombe L. Latex-safe carts for bedside patient care, Int J Trauma Nurs 1998:4:13-17
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.