Latex Sensitivity Management: Policies & Procedures | Staff Education | Patient Care Information | Product Information | References
 
Number: 30-04.11
Review Responsibilities: Nursing Practice Committee
Initial Approval: July 1, 1996
Last Revision Effective: August 30, 1999

LATEX ALLERGY MANAGEMENT

  1. Outcome Goal

    2.  
    Patient safety will be maintained by providing a latex safe environment to those patients who have been identified as having a latex allergy, spina bifida, congenital urological anomalies or have been medically advised to avoid latex. 
     
  2. Policy

    3.  
    All patients will be assessed on each admission/encounter for a history of allergies. Patients identified as having a latex allergy, spina bifida, congenital urological anomalies or who have been medically advised to avoid latex will require latex precautions and be cared for in a latex safe environment.
     
  3. Specific Information

    4.  
    A. Does implementation require MD order? ______Yes __X__ No

    B. Guidelines applicable to: 

    __X__  All patient care areas

    ______Adult areas

    ______Pediatrics areas

    ______Selected unit(s) - Specify: ______________________________________

    C. Team members performing:

    __X__ RN

    __X__ LPN

    __X__ Other licensed staff - Specify: All individuals participating in patients care

    __X__ Non-licensed staff – Specify: All individuals participating in patients care

    D. Specific education required: __X__ Yes _____ No

    Latex Sensitivity/Allergy education in Hearts and Minds orientation.
     

  4. Special Instructions
    1. Identification:
Patients needing latex precautions will be identified in the following ways:
      1. Documentation of latex sensitivity on referral slips and requisitions.
      2. Purple latex allergy sticker located on the inpatient’s identification bracelet or outpatient’s clothing.
      3. Purple latex allergy sticker located on the patient’s chart
      4. Purple latex precaution sign on door / exam area
      5. Medication Administration Record (MAR)
    1. Reaction Prevention and Management
      1. Patients will be placed in a private exam area/room prepared to provide a latex safe environment. For clinic visits or outpatient procedures, schedule the known latex sensitive patient as the first appointment of the day when airborne particles are the lowest whenever possible.
Note: Avoid placing Latex Sensitive/Allergic patient in the Isolation Rooms because they are negative pressure and will draw latex allergens into the room.

To prepare a latex safe environment:
      1. Remove all latex containing products (gloves, tourniquets, tape, etc.) from the room. If latex product cannot be removed, items should be located in a closed storage area, such as, cabinets and drawers.
      2. After removing latex items, thoroughly clean patient’s room/exam area using latex free (Nitrile or vinyl ) gloves to remove contaminated latex-containing dust. Do not wear latex or rubber gloves to clean room. 
      3. Bed mattress/exam tables do contain latex and should be covered completely with a sheet.
      4. Restock room with the latex free starter bundle and latex free gloves. 
      5. Place purple Latex precaution sign (located in starter bundle) on patient’s door/exam area.
      6. Stock room with latex free supplies needed for that patient; monitor and re-order the latex-free supplies as needed.
    1. Prior to contact with patients requiring latex precautions, personnel will wash hands to remove latex proteins. 
    2. The need for latex precautions will be communicated before a latex sensitive patient is sent to another department or another department provides services. For all non-emergency procedures, the sensitive patient should be scheduled as the first case of the day. 
    3. Consult dietitian to evaluate food sensitivity associated with latex allergy.
    4. Pharmacy will prepare and provide all medication according to their protocol for all patients requiring latex precautions.
    5. Anaphylaxis drug kit (available from Pharmacy) will be stored in the Sur-med system. Anaphylaxis medications will be stored in code cart or a secured area that permits immediate availability for patient use. All emergency carts prepared by Central Processing will be maintained as latex free except those items, which do not have a latex free alternative. These items will be labeled as containing latex. Emergency/Specialty areas will be responsible for addressing the latex content in their specialty carts and tackle boxes.
    6. If contact with a latex product cannot be avoided, consult physician for orders to pre-medicate for prophylaxis. 
    7. Care givers who observe allergic reactions such as skin rashes; hives; flushing; itching; nasal, eye, or sinus symptoms; respiratory distress; and (rarely) shock in patients following the use of latex-containing products should report this reaction immediately to the patient’s physician. Treat as clinically indicated for any allergic/anaphylactic reaction.
Note: Complete an occurrence report on all suspected or actual reactions.
    1. Latex-free Products / Information
Identify latex content for patient care items (i.e. package label, Nova smart screen, department’s list or manufacturer documentation). For questions regarding latex content of a particular product, contact either Medical Purchasing or Service Center. Identification of latex content in items obtained through other avenues is the responsibility of the department making the purchase.
  1. Patient/Family Education
    1. Patient/family will verbalize understanding of the following topics:
      1. Level of latex sensitization: Latex Risk or Latex Allergy. 
      2. Need to disclose the risk/allergy information with each healthcare encounter.
      3. Signs and symptoms of allergic reaction and appropriate management.
      4. Identification and use of non-latex products at home and in community settings (i.e. school)
      5. Risk of certain foods to latex allergic reactions.
      6. Provide patient with information on how to obtain a medical alert bracelet.
  1. Documentation
    1. The nurse shall document the following information in the chart:
      1. The use of latex free supplies and precautionary measures taken
      2. Any latex reaction and management/treatment
      3. The referral to Nutritional Services
      4. Patient and family education
  1. Cross References
    1. Patient Care Resource Manual:

      2. 30-04.10, “Anaphylactic Reaction Management”
    2. A web page http://www.mc.vanderbilt.edu/pcs/quality/latex/index.html to view policy / protocols, education, order sets, etc.
    3. Staff Education Materials:

      4. Video: Latex Allergy Management (4 min)
    4. Patient Education Index:

      5. “Latex Allergy in the Home,” DN# 01558-HC-4/95
    5. Protocols for Nutrition Service, Laboratory, Respiratory Therapy, Pharmacy, IV Therapy, Operative Services and Outpatient Practices
    6. NOVA Nurse supplier – “Latex Free Supplies”
  1. References

    2.  
    NIOSH (The National Institute for Occupational Safety and Health) [1997]. Alert Preventing AllergicReactions to Natural Rubber Latex in the Workplace. DHHS 97-135 (1-16).

    Barton, E.C. (1993). Latex Allergy: Recognition and Management of a Modern Problem. 
    Nurse Practitioner, 18: 11.

    Meeropol, E., Leger, R., and Frost, J. (1993). Latex Allergy in Patients with Myelodysplasia and in Health Care Providers: a Double Jeopardy. Urologic Nursing, 13: 39-44.

    Shapiro, E., Kelly, K.J., Setlock, M.A., Suwalski, K., and Meyers, P. (1992). Complications of  Latex Allergy. Dialogues in Pediatric Urology, 15.
     

  2. Distribution

    3.  
    A, B, C, D, F, G
     
  3. Contributors

    4.  
    Mary Gaines, BSN, RN, Quality Consultant, Quality Resource Services

    Vicki Brinsko, BS, RN, Infection Control

    April Samuelson, LPN, Quality Analyst, Quality Resource Services

    Wilson Matthews, RN, Life Flight 

    John Murray, MD, Allergy/Pulmonary & Critical Care Medicine

    All Latex Allergy Committee Members
     

  4. Endorsements

    5. /S/ Marilyn Dubree                                                   8/12/99
    ------------------------------------------------                     ----------------------
    Director, Patient Care Services and Chief Nursing Officer

    /S/ John Murray, MD                                                 8/12/99
    ------------------------------------------------                     ----------------------
    Medical Director Latex Allergy Committee


 
Latex Sensitivity Management: Policies & Procedures | Staff Education | Patient Care Information | Product Information | References
 
© 1999 Vanderbilt University Medical Center
URL: http://www.mc.vanderbilt.edu/pcs/quality/latex/vumcpolicy.html
Last Modified: November 15, 1999
mary.gaines@mcmail.Vanderbilt.Edu