Selection and Use of Personal Protective Equipment PPE

Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings. Centres for Disease Control and Prevention Website Infection Control Service CDHB

Aim of Session • Provide information on the selection and use of PPE in healthcare settings. • Practice how to safely don and remove PPE

PPE is defined as. . . • “Specialised clothing or equipment worn by an employee for protection against infectious materials” • PPE means Personal Protective Equipment e. g masks, gloves, gowns aprons (OSHA) Centres for Disease Control and Prevention web site.

Key points about PPE • Put on before contact • Use carefully – don’t spread contamination • Remove and discard with care as soon as possible after use • Immediately perform hand hygiene after removal of PPE

Personal Protection Measures (MOH Guidelines 2006) Risk level Hand Hygiene Social distance Cough and sneeze etiquette Adequate ventilation Masks Gloves If direct contact likely Lower to Medium For people who can maintain more than one meter from those potentially infected Medium For those who may be unable to maintain over a 1 meter distance from those potentially infected Surgical Medium to High For those who cannot maintain at least 1 meter distance for those potentially infected Surgical High For those who cannot maintain at least 1 meter distance AND are performing high risk procedures (suctioning) N 95/P 2 Gown Or Apron Eye protection

Sequence* for putting on PPE • • Gown first Mask Goggles or face shield/visor mask Gloves * Combination of PPE will affect the sequence when putting it on - be practical

How to put on a gown

How to put on a Mask • Place over nose, mouth and chin • Fit flexible nose piece over nose bridge • Secure on head with ties or elastic • Adjust to fit

How to put on a Particulate Respirator mask (N 95 or similar) • Select the appropriate size mask • Place over nose, mouth and chin • Fit flexible nose piece over nose bridge (take time to ensure good contour over nose is achieved) • Secure on head with elastic • Adjust to fit • Perform a fit check – - inhale – respirator mask should collapse - exhale – check for leakage around face

Demonstration Respirator mask (N 95 or similar)

How to put on Eye and Face Protection • Position goggles over eyes and secure to the head using the ear pieces or headband • Position face shield over face and secure on brow with head band • Adjust to fit comfortably

How to put on Gloves • • Put on gloves last Select correct type and size Insert hands into gloves Extend gloves over isolation gown cuffs

How to Safely use PPE • Keep gloved hands away from face • Avoid touching or adjusting other PPE • Remove gloves if they become torn; perform hand hygiene before putting on new gloves • Limit surfaces and items touched

Safely Removing PPE

“Contaminated” & “Clean” Areas of PPE • Contaminated = outside front Areas of PPE that have or are likely to have been in contact with body sites materials, or environmental surfaces where infectious organisms may reside • Clean = inside, outside back, ties on head and back Areas of PPE that are not likely to have been in contact with infectious organism

Sequence for Removing PPE 1. Gloves (followed with hand hygiene) 2. Face shield or goggles 3. Gown 4. Mask or respirator mask

Where to Remove PPE • At doorway, before leaving patient room or in anteroom* • If N 95 used, remove outside room, after door has been closed* * Ensure hand hygiene facilities are available at the point needed, e. g. , sink or alcohol hand gel

How to Remove Gloves (1) • Grasp outside edge near wrist • Peel away from hand, turning glove inside-out • Hold in opposite gloved hand

How to Remove Gloves (2) • Slide ungloved finger under the wrist of the remaining glove • Peel off from inside, creating a “bag” for both gloves • Discard into appropriate waste bin

Remove goggles or visor • Grasp ear or head pieces with ungloved hands • Lift away from face • Place in designated receptacle for reprocessing or disposal

Removing Isolation Gown • Unfasten ties • Peel gown away from neck and shoulder • Turn contaminated surface to inside (so that surface which was against your clothes faces out) • Fold or roll into a bundle • Discard into appropriate waste bin

Removing a Mask/visor mask • Untie the bottom, then top tie • Remove from face • Discard into appropriate waste bin

Removing a Particulate Respirator • Lift the bottom elastic over your head first • Then lift off the top elastic • Discard

Hand Hygiene • Perform hand hygiene immediately after removing PPE - if hands become visibly contaminated during PPE removal, wash hands before continuing to remove PPE • Wash hands with soap and water or use Alcohol hand gel *Ensure hand hygiene facilities are available at point needed, e. g. , sink or alcohol hand gel

Final Thoughts • PPE is personal protective equipment • PPE is available to protect you from exposure to infectious agents in the healthcare work place • Know what type of PPE is necessary for the duties you perform and how to use it correctly