1. AHRQ Safety Program for Long-term Care: HAIs/CAUTI Personal Protective Equipment Training Module 3 for All Long-Term Care Staff Current as of June 2015

2. Upon completion of this training, long-term care facility staff will be able to: Describe when to use personal protective equipment Gloves Gowns Masks and facewear Demonstrate how to put on and take off PPE 2 Learning Objectives

3. Personal Protective Equipment (PPE) PPE Gloves Gown Facewear 3

4. What PPE to Wear and When? Based on the type of task being performed Anticipated contact with blood and/or body fluids, or pathogen exposure Prevention of fluid penetration from splashing/sprays STOPSTOP CDC/HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Table 4. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 4

5. When to Wear Gloves Any anticipated contact with: – Blood or body substances—fluids and solids – Mucous membranes—oral, nasal, conjunctival, rectal, genital – Non-intact skin—wounds, surgical incisions – Indwelling device insertion site—urinary catheter, IVs, feeding tube – Handling potentially contaminated items in the resident’s environment Visibly soiled equipment, supplies or linens which may have been in contact with blood or body fluids Shared equipment moving between residents CDC/HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 5

6. Glove Use: Putting On and Taking Off Putting on gloves If wearing gown, extend to cover wrist of gown Removing gloves Remember: outside of gloves are contaminated 1.Grasp outside of glove with opposite gloved hand; peel off. 2.Hold removed glove in gloved hand. 3.Slide fingers of ungloved hand under remaining glove at wrist. CDC/HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 6

7. When to Wear Gowns When anticipating contact of clothing or exposed skin with blood or body fluids, secretions, or excretions During procedures likely to generate splashes, sprays, or droplets of blood and body fluids (e.g., catheter insertion, emptying urine collection bags) When in contact with non-intact skin (e.g., large wounds, rashes, burns) Handling fluid containers likely to leak, splash, or spill when moved (e.g., bedside commodes, bedpans, urinals, emesis basins) CDC/HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 7

8. Gown Use: Putting On and Taking Off Putting on Gown: 1.Put on before gloves. 2.Fasten at back of neck and waist. Removing gown: Remember: outside of gown is contaminated 1.Remove gloves first. 2.Unfasten neck, then waist ties. 3.Remove gown using a peeling motion; gown will turn inside out. 4.Hold removed gown away from body, roll into a bundle and discard in room. CDC/HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 8

9. Masks and Eye Protection Wear during procedures likely to generate splashes, sprays, or droplets of blood and body fluids Masks – Dressing changes for PICC/central vascular access devices – Dressing changes on large open wounds – Care of residents with new onset or exacerbation of respiratory condition with increased sputum or nasal secretions – Consider when emptying urine collection bags (splash) or inserting/changing urinary catheters (spray) Mask and goggles/face shield – Irrigation of open wounds (infected or non-infected) – Oral or tracheal suctioning CDC/HICPAC 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html 9

10. Try It Yourself! Demonstrate Proper Use of PPE 10

11. Posters on PPE Use Reminders on Appropriate Use Role model positive behaviors 11

12. Take the Pledge… 12

13. Wrap-Up Discussion What are some challenges to using gloves and gowns? What are some solutions to these challenges? How can you help support a culture of safety around PPE use? 13

14. Stay Updated with Useful Resources 1.AHRQ Safety Program for Long-Term Care: HAIs/CAUTI websiteAHRQ Safety Program for Long-Term Care: HAIs/CAUTI website Login information Username: ltcsafety Password: ltcsafety 2.TeamSTEPPS ® for Long-Term CareTeamSTEPPS ® for Long-Term Care 14 3.Centers for Disease Control and Prevention: Guideline for Isolation Precautions Protecting Healthcare Personnel