1. Removal of PPE – Contaminated Staff
Infection Prevention & Control Team

2. Principles
There has been some concern why healthcare staff in the US and Spain have acquired Ebola from repatriated patients and a significant number of healthcare staff have acquired the disease in West Africa
Failure in the PPE or failure to follow protocols when getting out of PPE have been blamed but the cause of these healthcare acquired infections remains unclear

3. Principles (2)
The purpose of this procedure is to ensure that staff in contact with an “at risk” patient remove PPE with the minimum contact of potentially contaminated PPE with themselves
An “undresser” who will also be dressed in PPE will remove the PPE of contaminated staff
Undressing will take place in a contaminated buffer zone, which is marked in amber on the floor plans (according to where the patient is isolated)

4. Step 1
Contaminated staff leave the patient’s room and enter the undressing area
Undresser
UNDRESSING AREA
CLEAN ZONE

5. Step 2
Undresser unties the gown

6. Step 3
Placing hands beneath the gown, push the gown forwards over the arms
If there is a second contaminated person, then repeat before proceeding further

7. Step 4
Roll the gown forwards, ensuring the outside of the gown does not touch the all-in-one oversuit
If possible, take the outer gloves off with the all-in-one oversuit

8. Step 5
Dispose of the gown
Staff member being undressed to keep their hands away from their body

9. Step 6
Remove outer gloves if they have not already come off, taking care not to pull inner gloves off
Undresser dips hands in Actichlor plus (hypochlorite) solution

10. Step 7
Remove visor, pulling forwards and away from the face
Dip hands in Actichlor plus (hypochlorite)

11. Step 8
Fully undo zip to all-in-one oversuit

12. Step 9
Roll all-in-one oversuit down, avoiding the outside of the oversuit touching either the scrubs or skin

13. Step 10
Continue to roll the all-in-one oversuit down, avoiding the outside of the oversuit touching either the scrubs or skin

14. Step 11
Roll all-in-one oversuit down the body
NB: gloves may come off during this process

15. Step 12
Continue to roll all-in-one oversuit down to knees

16. Step 13
Person being undressed shuffles back to a chair on the clean/dirty line, ensuring gloved hands do not touch skin/scrubs

17. Step 14
One trouser leg of all-in-one oversuit, shoe and overboot removed and disposed of

18. Step 15
Person being undressed avoids putting foot on the floor, or puts foot on the INSIDE of the all-in-one oversuit

19. Step 16
Undressed person places foot into the clean area

20. Step 17
Undresser removes all-in-one oversuit, second shoe and overboot
NB: a third person in the clean area can support the person sitting in the chair

21. Step 18
Undressed person places second foot into the clean area
Gloved hands kept over contaminated area

22. Step 19
Inner gloves removed

23. Step 20
Straps to face mask and goggles can be cut by a 3rd person in the clean area
They are taken by the undresser and disposed of within the undressing area
Individual can now leave clean area for shower