Phlebotomy · Safety and Compliance · 6 min read
Hand Hygiene, PPE and Glove Use
- Identify the correct methods, indications, and techniques for performing hand hygiene in phlebotomy practice.
- Explain the principles of Standard Precautions and the appropriate selection, donning, and doffing of personal protective equipment.
- Apply professional standards for glove selection, fit, safe use, and disposal during blood collection procedures.
Foundations of Hand Hygiene and Fingernail Care
Hand hygiene is the single most effective method to prevent the spread of healthcare-associated infections. In your everyday role as a phlebotomy technician, cleaning your hands protects both you and the patients you serve. Phlebotomists must perform hand hygiene before touching a patient, before putting on gloves and beginning a venipuncture or capillary puncture, after touching blood, body fluids, secretions, or contaminated items, immediately after removing gloves, and after touching objects or surfaces in the patient's immediate environment.
Alcohol-based hand rub is the preferred method for routine hand hygiene when hands are not visibly soiled. To use it properly, apply the product to all hand surfaces and rub continuously until completely dry. Think of it like applying lotion where every single spot must be covered; stopping early leaves the process incomplete. However, soap and water must be used when hands are visibly soiled with blood or body fluids. Additionally, after caring for a patient with suspected or confirmed Clostridioides difficile infection, follow facility precautions for hand hygiene; soap and water is recommended, particularly during outbreaks.
Handwashing with soap and water requires scrubbing all hand surfaces with friction for at least 20 seconds. During rinsing, hands must be rinsed under running water with fingertips pointed downward to prevent contaminated water from running up the arms. If the faucet is hand-operated, use a clean paper towel to turn it off after handwashing to avoid recontaminating clean hands.
Your fingernails also play a major role in infection control. Natural nail tips should be kept short to avoid tearing gloves and harboring infectious microorganisms. Furthermore, artificial nails and nail extenders can harbor pathogens, so phlebotomists must follow facility restrictions on their use in patient care.
| Method | Primary Indications | Proper Application Technique |
|---|---|---|
| Alcohol-Based Hand Rub | Routine hand hygiene when hands are not visibly soiled. | Apply to all hand surfaces and rub continuously until completely dry. |
| Soap and Water | Visibly soiled hands (blood/body fluids) and suspected/confirmed Clostridioides difficile care. | Scrub all surfaces with friction for at least 20 seconds, rinse with fingertips downward, and use a paper towel to turn off hand-operated faucets. |
Common mistakes
- Cutting or ripping the index fingertip off a glove to palpate the vein after cleaning the site, which is strictly prohibited by safety standards.
- Removing an N95 respirator inside an airborne isolation room instead of stepping outside and closing the door first.
- Assuming personal prescription eyeglasses provide adequate eye protection during procedures likely to generate splashes.
- Washing, sanitizing, or reusing disposable medical examination gloves between patients rather than discarding them and putting on a fresh pair.
Key points
- Hand hygiene is the single most effective method to prevent healthcare-associated infections and must be performed before touching patients, before gloving, after contamination, after removing gloves, and after touching patient surroundings.
- Alcohol-based rub is preferred when hands are not visibly soiled, whereas soap and water scrubbing for at least 20 seconds is required for visibly soiled hands and recommended for Clostridioides difficile.
- Standard Precautions treat blood, body fluids, secretions, and excretions other than sweat, as well as non-intact skin and mucous membranes, as potentially infectious for every patient encounter.
- Standard donning order is gown, mask/respirator, eye protection, and gloves; standard doffing order is gloves, eye protection, gown, and mask/respirator.
- Respirators worn for Airborne Precautions require a user seal check upon donning and must be removed outside the patient room after closing the door.
- Medical examination gloves must fit properly, must never be washed or reused, and must be changed between patients; powdered medical examination gloves are prohibited in the United States.
- Any PPE defect or supply shortage must be reported to the immediate supervisor, and hand hygiene must always follow PPE removal.
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