PPE, standard and transmission-based precautions

Info from "Safety and Protection" category of the Content Master app (PPE, precautions, etc. in safety and protection) and infection control FCs in BPC (PTA semester 1)

What are contact modes of transmission and infections?

• Spread through direct physical contact or indirect contact with an object (doorknobs, phones, etc.)

• Infections: MRSA, VRE, VISA, Scabies, Impetigo, Lice, Ebola, Zika

What PPE is used for contact?

• Gown and gloves (in that order)

• Lice - add a hair net

• Ebola - add extra pair of gloves, surgical mask, face shield

• Zika - surgical mask, extra pair of gloves

What are strict contact modes of transmission and infections?

• Same as contact

• Infections: C-diff

What PPE is used for strict contact?

• Gown, gloves, hand washing (soap and water)

What are droplet modes of transmission and infections?

• Spreads through mucous membranes or close respiratory contact with respiratory secretions

• Infections: Rubella (Mumps), meningitis, influenza, pertussis (Whooping cough), bacterial pneumonia, strep aureus

What PPE is used for droplet?

• Gown, gloves, N-95? or surgical mask w/face shield, eye protection

What are airborne modes of transmission and infections?

• Infectious agents remain infectious over long distances because they are suspended in the air

• Infections: Measles (rubeola), tuberculosis

What PPE is used for airborne and airborne + contact?

Gown, gloves, N-95

What are airborne + contact infections?

Infections: Disseminated Herpes Zoster (Shingles), Smallpox, Varicella Zoster (chickenpox)

What are airborne + contact + droplet infections?

Infections: SARS COVID 19, MERS (middle eastern respiratory syndrome)

What PPE is used for airborne + contact + droplet?

Gown, gloves, N-95, and eye protection

What are reverse contact diseases?

Cancer, HIV

What PPE is used for reverse contact?

Gloves and surgical mask

Aseptic techniques (clean approach

• Private rooms

• Natural barriers: skin and cilia of lungs

• Hand hygiene

• PPE use and disposal

What is the sterile technique (sterile approach)?

• Surgical hand scrub

• Sterilization of all instruments (steam, ethylene oxide gas, dry heat, EPA-approved chemical sterilant)

• Donning sterile gloves, mask, face shield, and gown

• Creating a sterile field

What is a pathogen? How are they spread?

• A microorganism that produces disease

• Can be spread via contact, droplets, the air, and the environment

What are ways to sterilize?

Done through the use of steam, dry heat, or chemical sterilant

What are ways to decontaminate equipment?

Done by hand washing, cleaning up messes, and properly disposing of PPE

What are infectious agents?

Includes communicable pathogens (fungi, bacteria, protozoa, etc.)

What is a reservoir?

A place where microorganisms can “hang out,” grow, and reproduce (ex. humans, animals, food, soil)

What is an exit (for infections)?

A means of leaving a host (nose, mouth, eyes, ears, intestines, etc.)

What is transmission (of diseases)?

How infections are spread including: contact, droplet, air, etc.

What is infection?

When a pathogen enters into a break in the skin, mucous membrane, nose, ear, etc. and spreads

What is susceptibility (to infection or disease)?

How vulnerable a person is to microorganisms

Goggles and mask PPE are removed before leaving the room.

False - Only gloves and gown can be removed in the room

What is the infection cycle?

• 1 - Infectious agent (bacteria fungi protozoa, etc.)

• 2 - Reservoir (humans, food, water, etc.)

• 3 - Exit (open wound, respiratory tract, bodily fluids)

• 4 - Method of transmission (soiled dressings, ingestion of contaminated food or water, respiratory droplets)

• 5 - Entry (into a cut, urinary/respiratory tract, etc.)

• 6 - Susceptible host (person with low systemic resistance, not fully immunized children, the elderly)

What is the correct sequence to don PPE?

1) Perform hand hygiene

2) Gown

3) Mask

4) Goggles/face shield

5) Gloves

What is the correct sequence to doff PPE?

1) Gloves (remember outside is contaminated)

2) Goggles/face shield (by touching only headband or earpieces)

3) Gown (front and sleeves are contaminated; roll into ball from inside out)

4) Mask (only touch the ties)

5) Hand hygiene

What are standard precautions?

Guidelines designed for the care of all patient REGARDLESS of infection or diagnosis

• Apply to ALL blood, bodily fluids, secretions and excretions (EXCEPT for sweat), nonintact skin, mucous membranes

When is soap and water the preferred method of hand hygiene over alcohol-based hand sanitizers?

Only when the hands are visibly dirty, before eating, and after using the restroom

When should someone us alcohol-based hand sanitizers?

• Before touching a patient

• Before an aseptic task

• Before moving from a soiled body site to a clean one

• After contact with blood, bodily fluids, or contaminated surfaces

• After glove removal

What are things to remember when using alcohol-based sanitizers?

• Remove jewelry from hands and wrists

• Cover hands and rub until the are dry (approx. 20 sec)

What are things to remember when using soap and water?

• Remove jewelry from hands and wrists

• Wet hands then apply soap

• Cover hands and rub until the are dry (approx. 30 sec)

• Rinse hands with water and use disposable towel to dry, then use a clean towel to turn off the facet

What are general principles of using PPE?

• Use when interaction may involve contact with blood or bodily fluids and in proportion to the anticipated level of exposure

When are glove or gowns appropriate to use?

• When contact with items, blood, bodily fluids, secretions, excretions (expect sweat), mucous membranes, nonintact skin, or contamination skin is expected

When are masks and protective eyewear appropriate to use?

When working with a patient and your mucous membranes of the eyes, nose, and mouth are susceptible to splashes or spray of bodily fluids, blood, or secretions and excretions (except sweat)

Direct contact

Skin-to-skin transmission

Indirect contact transmission

Contact with a contaminated object, usually within a patient’s environment