Should Gloves Be Worn When Giving Allergy Shots?

A common question patients ask is whether nurses and or other medical staff be wearing gloves when giving allergy shots (or other forms of immunization).
According to the CDC:

"Gloves are not required when administering vaccinations, unless persons administering vaccinations are likely to come into contact with potentially infectious body fluids or have open lesions on their hands." [link]

As such, the practice of wearing gloves is left up to the discretion of the person administering the shot.

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Some offices/hospitals may have a policy in place that makes it mandatory, but technically it is not required.

Of course, many individuals will point out a conflicting policy based on "Universal Precautions" which can potentially be interpreted as mandatory use of barrier protection (like gloves) whenever there is the possibility of bloodborne pathogen transference (which some may interpret as risk is always present).

However, if one actually reads the Universal Precautions put out by the CDC as it relates to blood drawing (considered higher risk than immunizations),

"In universal precautions, all blood is assumed to be potentially infective for bloodborne pathogens, but in certain settings (e.g., volunteer blood-donation centers) the prevalence of infection with some bloodborne pathogens (e.g., HIV, HBV) is known to be very low. Some institutions have relaxed recommendations for using gloves for phlebotomy procedures by skilled phlebotomists in settings where the prevalence of bloodborne pathogens is known to be very low. Institutions that judge that routine gloving for all phlebotomies is not necessary should periodically reevaluate their policy. Gloves should always be available to health-care workers who wish to use them for phlebotomy." [link]

Not quite the "mandatory" use of gloves some people stipulate when quoting Universal Precautions policy.


References:
General Recommendations on Immunization. CDC 2/8/02

Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings. CDC 6/24/88

Should Gloves Be Worn When Giving Allergy Shots?

A common question patients ask is whether nurses and or other medical staff be wearing gloves when giving allergy shots (or other forms of immunization).

According to the CDC:

"Gloves are not required when administering vaccinations, unless persons administering vaccinations are likely to come into contact with potentially infectious body fluids or have open lesions on their hands." [link]

 As such, the practice of wearing gloves is left up to the discretion of the person administering the shot.

Some offices/hospitals may have a policy in place that makes it mandatory, but technically it is not required.

Of course, many individuals will point out a conflicting policy based on "Universal Precautions" which can potentially be interpreted as mandatory use of barrier protection (like gloves) whenever there is the possibility of bloodborne pathogen transference (which some may interpret as risk is always present).

However, if one actually reads the Universal Precautions put out by the CDC as it relates to blood drawing (considered higher risk than immunizations),

"In universal precautions, all blood is assumed to be potentially infective for bloodborne pathogens, but in certain settings (e.g., volunteer blood-donation centers) the prevalence of infection with some bloodborne pathogens (e.g., HIV, HBV) is known to be very low. Some institutions have relaxed recommendations for using gloves for phlebotomy procedures by skilled phlebotomists in settings where the prevalence of bloodborne pathogens is known to be very low. Institutions that judge that routine gloving for all phlebotomies is not necessary should periodically reevaluate their policy. Gloves should always be available to health-care workers who wish to use them for phlebotomy." [link]

Not quite the "mandatory" use of gloves some people stipulate when quoting Universal Precautions policy.


References:
General Recommendations on Immunization. CDC 2/8/02

Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings. CDC 6/24/88

The Healthcare Dilemma Simplified

As an otolaryngologist in private practice, I have observed from the sidelines the healthcare crisis that is brewing in our nation, being debated in Congress, and bemoaned by fellow colleagues.

Being a simple man, I see the essence of the healthcare problem being summarized in one sentence:

"How to deliver low-cost, high-quality healthcare cheaply."

Being a simple man, I also realize that this statement is nearly impossible to accomplish for something as complex as healthcare delivery.

It's also a concept engineers have struggled with for way longer than medicine has. It is summarized by a great graphic known as the "Engineering Project Triangle". What is achievable is only where the colors overlap.

Design something quickly and to a high standard, but then it will not be cheap. 

Design something quickly and cheaply, but it will not be of high quality.

Design something with high quality and cheaply, but it will take a long time.

In other words, you can only pick two.

In terms of healthcare, the triangle could be known as the "Healthcare Project Triangle."

Design healthcare that is able to provide quality care at low-cost, than not everyone can have it. It's also known as "rationed" care which is what Canada and Great Britain have to some degree.

Design healthcare that is able to provide quality care to everybody, it will be expensive. This is where our healthcare model is currently situated.

Design healthcare this is able to provide low-cost care to everybody, it will suffer in terms of quality. Some would argue this is the HMO model. It's also what we could consider the kind of healthcare that is provided in free clinics.

In essence, you can't have healthcare with all three characteristics. You can only pick two.

Engineers know that and are probably wondering why doesn't everybody else.

"You can only pick two" is what the great debate is all about. Nobody can decide on which two and there are FANTASTIC arguments for the given two a Senator or presidential candidate will promote.

However, in the end, either quality, quantity, or low cost will suffer no matter which healthcare policy is chosen.

So the great debate has been identified...

The great question is what will be sacrificed?

Because unfortunately, there is no great answer.

Reference:
When Nurses Wear "Do Not Disturb" Signs. Dr. Wes.