REPORTING

Topic to be Presented PPE

Content What are PPE

Importance of wearing PP
Levels of PPE
Categories of PPE
Limitations
Medical PPE
GLOVES
GOWNS
FACEMASK
EYEWEAR
Fundamentals of Donning & Doffing
Process of Donning & Doffing with Demo

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CONTENT

What are PPE - Personal protective equipment, commonly referred to as

"PPE", is equipment worn to minimize exposure to hazards
that cause serious workplace injuries and illnesses. These
injuries and illnesses may result from contact with chemical,
radiological, physical, electrical, mechanical, or other
workplace hazards. Personal protective equipment may
include items such as gloves, safety glasses and shoes,
earplugs or muffs, hard hats, respirators, or coveralls, vests
and full body suits.
- All personal protective equipment should be safely designed
and constructed, and should be maintained in a clean and
reliable fashion. It should fit comfortably, encouraging worker
use. If the personal protective equipment does not fit
properly, it can make the difference between being safely
covered or dangerously exposed. When engineering, work
practice, and administrative controls are not feasible or do
not provide sufficient protection, employers must provide
personal protective equipment to their workers and ensure
its proper use. Employers are also required to train each
worker required to use personal protective equipment to
know:
- When it is necessary
- What kind is necessary
- How to properly put it on, adjust, wear and take it off
- The limitations of the equipment
- Proper care, maintenance, useful life, and disposal
of the equipment
 - If PPE is to be used, a PPE program should be
implemented. This program should address the hazards
present; the selection, maintenance, and use of PPE; the
training of employees; and monitoring of the program to
ensure its ongoing effectiveness.

Importance - according to the hierarchy of controls by the National

Institute for Occupational Safety and Health (NIOSH), PPE
(sometimes also referred to as PPE equipment)—is
recommended to be the last level of defense to prevent
occupational injuries, illnesses, and fatalities, but some
businesses combined it with other control measures to
ensure a safe and healthy environment for their workers.
Here are some benefits of using PPEs:
- prevent unnecessary injury in the workplace;
- protect employees from excessive chemical
exposure;
- prevent the spread of germs and infectious diseases
including COVID-19;
- help businesses comply with regulatory
requirements(e.g., The Personal Protective
Equipment at Work Regulations 1992 that’s recently
been extended to limb workers); and
- improve employee productivity and efficiency.

Levels of PPE Personal protective equipment is divided into four categories based
on the degree of protection afforded.

LEVEL A
- Level A protection should be worn when the highest level of
respiratory, skin, eye and mucous membrane protection is
needed.
- A typical Level A ensemble includes:
- Positive pressure (pressure demand)
- self contained breathing apparatus (SCBA) (NIOSH
approved), or positive-pressure supplied air
respirator with escape SCBA.
- Fully encapsulating chemical protective suit.
- Gloves, inner, chemical resistant.
- Gloves, outer, chemical resistant.
- Boots, chemical resistant, steel toe and shank;
(depending on suit boot construction, worn over or
under suit boot.)
LEVEL B
- Level B protection should be selected when the highest level
of respiratory protection is needed, but a lesser level of skin
and eye protection is needed.
- Level B protection is the minimum level recommended on
initial site entries until the hazards have been further
identified and defined by monitoring, sampling, and other
reliable methods of analysis, and equipment corresponding
with those findings utilized.
- A typical Level B ensemble includes:
- Positive-pressure (pressure-demand), self-contained
breathing apparatus (NIOSH approved), or
 positive-pressure supplied air respirator with escape
SCBA.
- Chemical resistant clothing (overalls and
long-sleeved jacket, coveralls, hooded two-piece
chemical splash suit, disposable chemical resistant
coveralls.)
- Gloves, outer, chemical resistant.
- Gloves, inner, chemical resistant.
- Boots, outer, chemical resistant, steel toe and
shank.
LEVEL C
- Level C protection should be selected when the type of
airborne substance is known, concentration measured,
criteria for using air-purifying respirators met, and skin and
eye exposure is unlikely.
- Periodic monitoring of the air must be performed. A typical
- Level C ensemble includes:
- Full-face or half-mask, air-purifying respirator
(NIOSH approved).
- Chemical resistant clothing (one piece coverall,
hooded two piece chemical splash suit, chemical
resistant hood and apron, disposable chemical
resistant coveralls.)
- Gloves, outer, chemical resistant.
- Gloves, inner, chemical resistant.
- Boots, steel toe and shank, chemical resistant.
LEVEL D
- Level D protection is primarily a work uniform and is used for
nuisance contamination only. It requires only coveralls and
safety shoes/boots. Other PPE is based upon the situation
(types of gloves, etc.).
- It should not be worn on any site where respiratory or skin
hazards exist.

Categories of Protection Face and Eye Protection

PPE includes safety goggles and face shields to protect against eye
damage from sprays, splashes, and burns.

Safety Tips:
- Use safety glasses compliant with the ANSI Z87.1 standard.
- Check for cracks or deformities in lenses.
- Ensure the strap is in good condition and fits securely.
- Clean and disinfect after use.

Respiratory Protection
PPE includes respirators, gas masks, N95 respirators, and surgical
masks to prevent inhaling harmful gases, chemicals, or pathogens.

Safety Tips:
- Fit-test equipment and train employees before use.
- Follow instructions to ensure proper protection.
- Regularly change filters on respirators and replace disposable
masks after use.
- Do not share surgical masks, and dispose of them after each use.
 Skin and Body Protection

Head Protection
PPE like hard hats protects against falling objects.

- Check for dents or deformities.

- Avoid storing in direct sunlight.
- Replace after any impact.

Body Protection
Includes vests and suits to protect from extreme temperatures,
chemicals, and radiation.

- Keep clean and check for cuts or burns.

- Ensure a proper fit for full protection.
- Use heat-resistant clothing for high-temperature tasks.

Hands Protection
PPE includes gloves to protect against burns, cuts, and harmful
substances.

- Ensure gloves fit snugly and are free of damage.

- Replace if contaminated.
- Use rubber gloves for heat and electrical work.

Foot Protection
Includes safety boots and knee pads to guard against falling objects,
heat, and slippery surfaces.

- Use slip-resistant soles.

- Check sole plates for puncture protection.

Fall Protection
Includes harnesses and lanyards for tasks at heights.

- Check straps for tears and ensure buckles are secure.

- Dispose of equipment after a fall incident.

limitations Decisions about PPE use must consider its limitations.

Safety Hazards
- Restricted movement due to weight
- Restricted vision due to visual field limitations
- Difficulty communicating due to face protection
Physiological/Psychological stressors
- Psychological stress resulting from confining nature of full
suits
- Heat stress and risk of dehydration
- The highest levels of PPE generally cannot be worn
continuously for more than 30 minutes
Management Requirements
- Need for a management program that ensures effective use
of PPE
- Facial hair interferes with proper fit of masks
- Improper use, penetration/tears are potentially hazardous
Gloves Gloves are worn for three reasons: First, they protect the hands
when the nurse is likely to handle any body substances, for example,
blood, urine, feces, sputum, and nonintact skin. Second, gloves
reduce the likelihood of nurses transmitting their own endogenous
microorganisms to individuals receiving care. Nurses who have open
sores or cuts on the hands must wear gloves for protection. Third,
gloves reduce the chance that the nurse’s hands will transmit
microorganisms from one client or an object to another client. In all
situations, gloves are changed between client contacts. The hands
are cleansed each time gloves are removed for two primary reasons:
1. The gloves may have imperfections or be damaged during
wearing so that they could allow microorganism entry and
2. the hands may become contaminated during glove removal.

Gowns Clean or disposable impervious (water-resistant) gowns or plastic

aprons are worn during procedures when the nurse’s uniform is likely
to become soiled. Sterile gowns may be indicated when the nurse
changes the dressings of a client with extensive wounds (e.g.,
burns). Single-use gown technique (using a gown only once before it
is dis-carded or laundered) is the usual practice in hospitals. After
the gown is worn, the nurse discards it (if it is paper) or places it in a
laundry hamper. Plastic aprons should be discarded after use.
Before leaving the client’s room, the nurse cleanses his or her
hands.

Face Masks Masks are worn to reduce the risk for transmission of organisms by
the droplet contact and airborne routes and by splatters of body
substances. The CDC recommends that masks be worn:
● By those close to the client if the infection (e.g., measles,
mumps, or acute respiratory diseases in children) is
transmitted by large-particle aerosols (droplets). Large
particle aerosols are transmitted by close contact and
generally travel short distances (about 1 m, or 3 ft).
● By all individuals entering the room if the infection (e.g.,
pulmonary tuberculosis and SARS-CoV) is transmitted by
small-particle aerosols (droplet nuclei). Small-particle
aerosols remain suspended in the air and thus travel greater
distances by air. Special masks that provide a tighter face
seal and better filtration may be used for these infections.

Various types of masks differ in their filtration effectiveness and fit.

Single-use disposable surgical masks are effective for use while the
nurse provides care to most clients but should be changed if they
become wet or soiled. These masks are discarded in the waste
container after use. Disposable particulate respirators of different
types may be effective for droplet transmission, splatters, and
airborne microorganisms. Some respirators now available are
effective in preventing inhalation of tuberculin organisms. The
National Institute for Occupational Safety and Health (NIOSH), part
of the CDC and a research agency of the U.S. Department of Health
and Human Services, tests and certifies such respirators. Currently,
the category “N” respirator at 95% efficiency (referred to as an N95
respirator) meets tuberculosis, SARS, and influenza control
criteria.
 During certain techniques requiring surgical asepsis (sterile
technique), masks are worn (a) to prevent droplet contact
transmission of exhaled microorganisms to the sterile field or to a
client’s open wound and (b) to protect the nurse from splashes of
body substances from the client.

Eyewear Protective eyewear (goggles, glasses, or face shields) and masks

are indicated in situations where body substances may splatter the
face. If the nurse wears prescription eyeglasses, goggles must still
be worn over the glasses because the protection must extend
around the sides of the glasses.

Fundamental of Donning & Donning means to put on and use PPE properly to achieve the
Doffing intended protection and minimize the risk of exposure. Doffing
means removing PPE in a way that avoids self-contamination. For
example, avoid skin and mucous membrane contact with potentially
infectious materials, and chemical and biological agents.

Follow strict donning and doffing procedures, such as

observer-monitored methods and hot, warm, and cold zones, for
highly infectious agents. The following are important considerations
and tips:

- The exclusion zone (or hot zone) is the area with actual or
potential contamination and the highest potential for
exposure to hazardous substances.
- The contamination reduction zone (or warm zone) is the
transition area between the exclusion and support zones.
This area is where responders enter and exit the exclusion
zone and where decontamination activities take place.
- The support zone (or cold zone) is the area of the site that is
free from contamination and that may be safely used as a
planning and staging area.
- Remove PPE before entering any non-clinical areas
including restrooms, breakrooms, and administrative areas.
- Always wash hands with soap and water before wearing and
after removal of PPE.
- Dispose of all PPE in appropriate waste containers.

Process DONNING
Step 1:
- Remove personal items like jewelry, watches, coats,
cellphones, pens, and extra bags, and place them outside
the lab.
- Tie back long hair.
- Gather your solid front wrap-around gown, gloves,
disposable face mask (or N-95 respirator), and face shield.
Ensure the gown and gloves are the correct size.
- Visually inspect your PPE for any defects, such as rips or
tears, and replace them if needed.
Step 2:
- Put on the gown, fastening it securely behind your neck and
back or side. Ensure it fits well, and street clothing is not
exposed.
 Step 3:
- Put on your disposable face mask, securing the ear loops
behind your ears. Press the flexible nose piece to ensure a
snug fit against your nose and cheeks.
Step 4:
- Put on the face shield, placing the elastic strap behind your
head and adjusting it to fit snugly. Ensure the shield covers
your forehead, extends below your chin, and wraps around
the sides of your face.
Step 5:
- Put on your gloves by pulling the gown’s knit cuff down
around your palm and pulling the glove over the cuff. Check
for punctures or tears.

DOFFING
Step 1:
- Untie the gown, pull it off your shoulders, and roll it inside
out as you remove it. Avoid touching the contaminated
areas.
Step 2:
- As you remove the gown sleeves, pinch the gloves and
sleeves together to peel off the gloves. Roll the gown and
gloves into a bundle and dispose of them in the biohazard
container.
Step 3:
- Apply hand sanitizer, then remove the face shield by
grasping the straps above the ears and lifting it away from
your face. Dispose of it in the biohazard container.
Step 4:
- Remove the face mask by taking off the ear loops without
touching the exterior. Dispose of it in the biohazard
container.
Step 5:
- Wash your hands with soap and water for at least 20
seconds. If unavailable, use hand sanitizer containing at
least 60% ethanol or 70% isopropanol.

Precautions Standard Precautions

Standard precautions are used in any situations involving blood; all
body fluids, excretions, and secretions except sweat; non intact skin;
and mucous membranes (whether or not blood is present or visible).
SP include
A. hand hygiene
B. use of personal protective equipment (PPE), which includes
gloves, gowns, eyewear, and masks;
C. safe injection practices;
D. safe handling of potentially contaminated equipment or
surfaces in the client environment; and
E. respiratory hygiene or cough etiquette that calls for covering
the mouth and nose when sneezing or coughing, proper
disposal of tissues, and separating potentially infected
individuals from others by at least 1 m (3 ft) or having them
wear a surgical mask.

Transmission-Based Precautions
Transmission-based precautions are used in addition to standard
precautions for clients with known or suspected infections that are
spread in one of three ways: by airborne or droplet transmission, or
by contact. The three types of transmission-based precautions may
be used alone or in combination but always in addition to SP.

● Airborne precautions are used for clients known to have or

suspected of having serious illnesses transmitted by
airborne droplet nuclei smaller than 5 microns.
○ Examples of such illnesses include measles
(rubeola), varicella (including disseminated zoster),
and tuberculosis. The CDC has prepared special
guidelines for preventing the transmission of
tuberculosis. The most current information may be
found on the CDC Division of Tuberculosis
Elimination website.
● Droplet precautions are used for clients known to have or
suspected of having serious illnesses transmitted by particle
droplets larger than 5 microns.
○ Examples of such illnesses are diphtheria
(pharyngeal); mycoplasma pneumonia; pertussis;
mumps; rubella; streptococcal pharyngitis,
pneumonia, or scarlet fever in infants and young
children; and pneumonic plague.
● Contact precautions are used for clients known to have or
suspected of having serious illnesses easily transmitted by
direct client contact or by contact with items in the client’s
environment.
○ According to the CDC, such illnesses include GI,
respiratory, skin, or wound infections or colonization
with multidrug-resistant bacteria; specific enteric
infections such as C. difficile and enterohemorrhagic
E. coli O157:H7, Shigella, and hepatitis A, for
diapered or incontinent clients; respiratory syncytial
virus, parainfluenza virus, or enteroviral infections in
infants and young children; and highly contagious
skin infections such as herpes simplex virus,
impetigo, pediculosis, and scabies.