Recently one of my facilities removed the powder free gloves from stock. I have always used powder free gloves for PICC insertion because I was taught that the powder can cause problems. With the new change I needed to find research to back up my request. The only thing I can find in from the book Intravenous Infusion Therapy for Nurses 2nd edition 2004. It says that powder from the gloves can enter the site and act as a foreign body causing an inflammatory response. If this is still best practice I would like to make sure we are using powder free gloves for all central line insertions. Can anyone direct me to more current research to back this up? I did a quick scan of the CDC, SHAE, and INS guidelines as well as the Joint Commission monograph and I did not see anything specific about the powder issue. Thank you.
Antonia Tocco RN, VA-BC
I am probably one of very few people that can relate the history of this problem. The first PICCs were made of black silicone back in the early 1970's. The black color showed the extreme amount of particulate matter that became attracted to the silicone catheter. Silicone has a very high negative electrical charge so it draws lint, powder, any type of particulate. In the early days when silicone was all we had and there were no powder free gloves, we used sterile water or saline to wash the powder off of our gloves after we had put them on.
Polyurethane does not have the same level of high negative electrical charge but it does have some. So it is still good practice to use powder free gloves. I don't think this particulate matter issue has ever showed up on a study as one of the causes of phlebitis though. You might find this issue discussed in some of the old articles from the early 1980's but I can't recall a specific one now. You should check the instructions for use for the specific brand(s) used in your hospital to see what they are recommending about this issue. If there instructions do not address it, I would call their clinical department and get an answer in writing. Please note I am not talking about contacting your local sales rep!
Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861