By Karen Zulkowski DNS, RN, CWS
How often should you change gloves during a dressing change? In the past year I have learned of multiple nursing home facilities being cited for not changing their gloves after a dressing is removed to avoid bacterial cross-contamination during dressing reapplication. I have looked at the evidence and there is nothing out there, based on my research, that supports or denies this claim. The closest information found was on handwashing from the CDC and WHO. If you are from a facility that has been cited, please post what happened.
Bacteria is present on everyone’s skin. Basically, there are transient bacteria that you can wash off and resident bacteria that you always have. In the patient’s case this bacteria may be shed onto the bed and surrounding areas. This bacteria is also present in the patient’s wound—especially in the edges of the wound. Even after you wash the wound the bacteria is still going to return around the edges.
The idea is to prevent the bacteria present from being transmitted to another patient. Keep in mind that the amount and virulence of bacteria are mediated by the patient’s immune response. When a patient is immunocompromised, any bacteria can become problematic. Look at how all staff is washing their hands after patient contact. How long do they wash and is hand sanitizer available and being applied? Look around and post where you think your facility could improve their hand hygiene practices and tell us your suggestions for how they can be accomplished.
Later this year I am doing a pilot study on wound and hand bacteria. I will let you know what I find! In the meantime, I welcome hearing about your experiences. Feel free to post a comment on this blog.
About The Author
Karen Zulkowski DNS, RN, CWS is an Associate Professor with Montana State University-Bozeman, teaches an online wound course for Excelsior College, and is a consultant for Mountain Pacific Quality Improvement Organization. She has served as a Research Consultant with Billings Clinic Center on Aging, and was the Associate Director for Yale University’s Program for the Advancement of Chronic Wound Care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.