PPE refers to whatever protective equipment may be

used to insulate an individual from the hazards presented by the environment in which he or she is working In the healthcare environment it refers to specialised clothing or equipment worn by an employee or patient for protection against infectious materials and other contaminants The type of PPE used will vary based on the level of precautions required; such as, Standard, Contact, Droplet or Airborne Infection Isolation

Aims and Objectives

To ensure healthcare workers are aware of the

appropriate PPE required, in order to provide protection in conjunction with standard and transmission-based precautions Ensure healthcare workers are aware of the correct sequence for donning PPE Ensure healthcare workers are aware of the correct sequence for removing PPE in a manner that prevents self-contamination and self-inoculation

Purposes: To protect health care workers and clients from transmission of potentially infective materials. Delegation: Use of personal protective equipment is identical for all health care providers including unlicensed assistive personnel. Health care team members are accountable for proper implementation of these procedures by themselves and others.

Some important things to remember about PPE

Don PPE before contact with patient, generally before

entering the room Keep gloved hands away from the face and avoid touching or adjusting PPE Remove and discard PPE carefully. This should be done at the doorway (just prior to leaving patients room) or immediately outside patient room. Surgical or particulate masks should be removed outside room Immediately perform hand hygiene using soap and water or an alcohol-based gel or rub

Equipment:
As indicated according to which activities will be

performed. Ensure that extra supplies are easily available. Gown Mask Eyewear Clean gloves

GLOVES
- gloves are worn for three reasons: 1. They protect the hands when the nurse is likely to handle any body substances (e.g. blood, urine, feces, sputum, mucus membranes, and non-

intact skin) 2. Gloves reduce the likelihood of nurses transmitting their own endogenous microorganisms to individuals receiving care. Nurses who have the open sores or cuts on the hands must wear gloves for protection. 3. Gloves reduce the chance that the nurses hands will transmit microorganisms from one client to another client. In all situations, gloves are changed between client contacts.

The hands are washed each time gloves are removed for two primary reasons:
The gloves may have imperfections or be damaged

during wearing so that they could allow microorganisms entry. 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 nurses uniform is likely to become soiled. Single- use gown technique is the usual practice in hospitals. After the gown is worn, the nurse discards it or places it in a laundry hamper. Before leaving the clients room, the nurse washes his/her hands.

FACE MASK
Masks are worn to reduce the risk for transmission of

organisms by droplet contact and airborne routes, and by splatters of body substances. The Centres for Disease Control recommends that masks be worn under the following conditions: By those close to the client if the infection (mumps, measles, or acute respiratory diseases in children) is transmitted by large- particle aerosols (droplet). Large-particle aerosols are transmitted by close contact and generally travel short distances (about 1m.or 3 ft).

 By all persons entering the room if the infection

(pulmonary tuberculosis and SARS) 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. During certain technique requiring surgical asepsis, masks are worn a) to prevent droplet contact transmission of exhaled microorganisms to the sterile field or to the clients 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 may be indicated in situations where body substances may splatter the face. If the nurse wears prescription eyeglasses, goggles may be worn over the glasses. The protective eyewear must extend around the sides of the glasses.

Sequence for Donning PPE Gown/apron Surgical or particulate

mask Goggles or face shield Gloves

Step 1 Perform hand hygiene

Perform hand hygiene before putting on Personal

Protective Equipment (PPE) With soap and water, or Water-free skin cleanser.

Step 2 Gown/Apron Fully cover torso from neck to knee, arms to end of wrist, and wrap around the back.

. Fasten at back of neck and waist

Step 3 Surgical mask or particulate

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 particulate (P2 or N95) only.

 Gently inhale. When you breathe in the mask should

draw in slightly toward the face and collapse Gently exhale. The mask should fill up with air. It is important at this stage that there is no air leakage around the edges of the mask

If you have not achieved a successful fit check as instructed it is important that you seek advice or have someone assist you with fitting and checking your mask. An incorrectly fitted mask will not provide you with the intended level of protection from airborne infectious diseases

Step 4 Protective Eyewear

Place goggles or face

shield/visor over face and eyes and secure using the ear pieces or headband Adjust to fit comfortably

Step 5 Gloves
Don gloves last
Select correct size and type

Insert hands into gloves

Extend to cover wrist of gown

You are now ready and safe to enter the patients room

Safe use of PPE

Keep gloved hands away from face
Avoid touching or adjusting other PPE Change gloves when torn or heavily

contaminated Limit surfaces and items touched to prevent accidental contamination

Sequence for Removing PPE

Gloves
Face shields or goggles

Gown
Mask or respirator

It is important to remember that the sequence for removing PPE is intended to limit opportunities for self contamination and self inoculation Important to identify what sites or areas are considered clean and what are contaminated This is especially important when identifying the safest sequence for removal

Contaminated

Contaminated

Where to remove PPE

At the doorway, before leaving the patients room or in

the anteroom if available It is important to remove mask/ respirator outside room, after the door to patients room has been closed Hand washing facilities ( soap and water-free skin cleanser) should be readily available after all PPE is removed

Step 1 Gloves
Outside of gloves is contaminated
Grasp outside of glove with opposite gloved hand; peel

off Hold removed glove in gloved hand Slide fingers of ungloved hand under remaining glove at wrist Peel glove off over first glove Discard gloves into waste container

 Perform hand hygiene following removal of gloves

Using soap and water, or water-free skin cleanser Outside of goggles or face shield is contaminated To remove, handle by head band or ear pieces Place reusable eyewear in designated receptacle for

cleaning Or discard disposable eyewear into waste container for disposal

 Gown front and sleeves are

contaminated Unfasten ties at neck and waist Pull away from neck or shoulders, touching inside of gown only Turn gown inside out Fold or roll slowly into a bundle and discard into designated waste container

Front of mask is contaminated Remove by touching tapes or ties

only Discard in designated waste container

Remove mask when outside patients room

Perform hand hygiene following

removal of all Personal Protective Equipment (PPE), Using soap and water, or water-free skin cleanser