2. Prepared by: Haizell Libut

3. What is PERSONAL PROTECTIVE EQUIPMENT (PPE)? Personal Protective Equipment (PPE) is defined as “specialized clothing or equipment worn by an employee for protection against infectious materials” PPE is special equipment you wear to create a barrier between you and germs. This barrier reduces the chance of touching, being exposed to, and spreading germs.

4. Objectives in using PPE? Improve personnel safety in the healthcare environment through appropriate use of PPE. To ensure staff understand when to use PPE as part of standard and transmission based precautions To ensure staff understand what PPE equipment is available and where to access it To ensure staff understand how to don and remove PPE

5. What are the types of PPE? Gloves – protect hands Gowns/aprons – protect skin and/or clothing Masks and respirators– protect mouth/nose  Respirators – protect respiratory tract from airborne infectious agents Goggles – protect eyes Face shields – protect face, mouth, nose, and eyes

6. Gloves Gloves must be available and accessible in a range of sizes in all patient care areas. Wearing gloves reduces contamination of hands and minimizes the risk that a health care worker will become infected after contact with a patient’s blood or body substance. Wearing gloves reduces the likelihood that staff will transmit micro-organisms for their hands to patients. The type of glove used will depend on the task involved: Non sterile gloves: Non sterile gloves are suitable for most situations when contact with any blood or body substance, mucous membranes or non-intact skin is anticipated. Sterile gloves: Sterile latex gloves shall be worn for surgical procedures where asepsis must be maintained Staff involved with surgical procedures should double-glove for added protection

7. Gowns/ aprons Gowns/ aprons are to be worn to protect clothing and/or skin from becoming contaminated, soiled or wet from splashes or contact with blood or body substances, or during cleaning and disinfection Types of protective clothing: Plastic aprons In general, disposable plastic aprons are sufficient to provide protection from contamination Fluid Resistant Gown Long sleeved, disposable fluid resistant gowns should be used for contact isolation or where there is an elevated risk of contamination

8. Masks A mask shall be worn in any situation When splash or splatter with blood or body substance to the mucous membranes on the mouth and nose is anticipated To protect staff from inhalation of infectious aerosols or droplets, smoke or plume or other airborne hazards To prevent the spread of micro-organisms from the nasopharynx of staff of the patient to others who are susceptible. Types of masks: Surgical Mask (with or without visor) Used in wards, departments or operating theatres N95 Particulate Mask Used when caring for patients with diagnosed or suspected airborne infectious diseases

9. Eye/ Face Protection Eye/face protection shall be worn in any situation when splash or splatter with blood or body substance to the mucous membrane of the mouth, nose and or eyes in likely. Types of eye/face protection: Chin length plastic face shield Mask with visor attached Safety glasses with side shields Goggles Note: Prescription glasses do not provide adequate protection

10. Factors Influencing PPE Selection Type of exposure anticipated – Splash/spray versus touch – Category of isolation precautions Durability and appropriateness for the task Fit

11. Sequence* for Donning PPE Gown first Mask or respirator Goggles or face shield Gloves *Combination of PPE will affect sequence – be practical

12. General Considerations (Donning of PPE) Keep hands away from face. Limit surfaces touched. Change when torn or heavily contaminated. Work from clean to dirty.

13. 1. Hand Hygiene

14. 2. GOWN Select appropriate type and size Opening is in the back Secure at neck and waist If gown is too small, use two gowns – Gown #1 ties in front – Gown #2 ties in back Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back. Fasten in back of neck and wrist.

15. 3. MASK or RESPIRATOR How to don 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 Don a Particulate Respirator? Select a fit tested respirator Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with elastic Adjust to fit Perform a fit check – – Inhale – respirator should collapse – Exhale – check for leakage around face Secure ties or elastic bands at middle of head and neck. Fit flexible band to nose bridge. Fit snug to face and below chin. Fit-check respirator.

16. 4. GOGGLES or FACE SHIELD How to Don 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 headband Adjust to fit comfortably Place over face and eyes and adjust to fit. Anti-fog feature improves clarity.

17. 5. GLOVES How to Don Gloves? Select correct type and size Insert hands into gloves Extend gloves over isolation gown cuffs

18. 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 donning new gloves Limit surfaces and items touched

19. “Contaminated” and “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 the infectious organism may reside Clean – inside, outside back, ties on head and back Areas of PPE that are not likely to have been in contact with the infectious organism

20. Proper DOFFING of PPE

21. Sequence for Removing PPE Gloves Face shield or goggles Gown Mask or respirator Handwashing

22. Where to Remove PPE? At doorway, before leaving patient room or in anteroom* Remove respirator outside room, after door has been closed* *Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub

23. 1. GLOVES Outside of gloves are contaminated! If your hands get contaminated during glove removal, immediately wash your hands or use an alcohol-based hand sanitizer. Using a gloved hand, grasp the palm area of the other gloved hand and peel off first glove. Hold removed glove in gloved hand. Slide fingers of ungloved hand under remaining glove at wrist and peel off second glove over first glove. Discard gloves in a waste container.

24. 2. GOGGLES or FACE SHIELD Outside of goggles or face shield are contaminated! If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol- based hand sanitizer. Remove goggles or face shield from the back by lifting head band or ear pieces. If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container.

25. 3. GOWN Gown front and sleeves are contaminated! If your hands get contaminated during gown removal, immediately wash your hands or use an alcohol-based hand sanitizer. Unfasten gown ties, taking care that sleeves don’t contact your body when reaching for ties. Pull gown away from neck and shoulders, touching inside of gown only. Turn gown inside out. Fold or roll into a bundle and discard in a waste container.

26. 4. MASK or RESPIRATOR Front of mask/respirator is contaminated —DO NOT TOUCH! If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol- based hand sanitizer. Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front. Discard in a waste container.

27. 5. Hand Hygiene

28. When to Use PPE? Standard and Expanded Precautions Isolation Precautions

29. Standard Precautions Previously called Universal Precautions Assumes blood and body fluid of ANY patient could be infectious Recommends PPE and other infection control practices to prevent transmission in any healthcare setting Decisions about PPE use determined by type of clinical interaction with patient

30. PPE for Standard Precautions (1) Gloves – Use when touching blood, body fluids, secretions, excretions, contaminated items; for touching mucus membranes and nonintact skin Gowns – Use during procedures and patient care activities when contact of clothing/ exposed skin with blood/body fluids, secretions, or excretions is anticipated

31. What Type of PPE Would You Wear? Giving a bed bath? Suctioning oral secretions? Transporting a patient in a wheel chair? Responding to an emergency where blood is spurting? Drawing blood from a vein? Cleaning an incontinent patient with diarrhea? Irrigating a wound? Taking vital signs?

32. PPE for Expanded Precautions Expanded Precautions include – Contact Precautions – Droplet Precautions – Airborne Infection Isolation

33. Use of PPE for Expanded Precautions Contact Precautions – Gown and gloves for contact with patient or environment of care (e.g., medical equipment, environmental surfaces)  In some instances these are required for entering patient’s environment Droplet Precautions – Surgical masks within 3 feet of patient Airborne Infection Isolation – Particulate respirator* *Negative pressure isolation room also required

34. Hand Hygiene Required for Standard and Expanded Precautions Perform… – Immediately after removing PPE – Between patient contacts Wash hands thoroughly with soap and water or use alcohol-based hand rub

35. PPE for Standard Precautions (2) Mask and goggles or a face shield – Use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

36. Thank you!!