Guidance for Selection + Use of Personal Protective Equipment (PPE) in Healthcare Settings

what is the goal of PPE USE in healthcare settings

improve personnel safety in healthcare environment through appropriate use of PPE

what is PERSONAL PROTECTIVE EQUIPMENT (PPE)

specialized clothing/equipment worn by an employee for protection against infectious materials

what are 5 types of PPE used in healthcare settings

1. gloves

2. gowns/aprons

3. masks + respirators

4. goggles

5. face shields

what is the purpose of GLOVES

protect hands

what is the purpose of GOWNS/APRONS

protect skin/clothing

what is the purpose of MASKS + RESPIRATORS

protect mouth/nose

what is the main purpose of RESPIRATORS

protect respiratory tract from airborne infectious agents

what is the purpose of GOGGLES

protect eyes

what is the purpose of FACE SHIELDS

protect face, mouth, nose + eyes

what are 3 factors that INFLUENCE PPE SELECTION

1. type of exposure anticipated

2. durability + appropriateness for task

3. fit

what are 2 types of EXPOSURE ANTICIPATED

1. splash/spray vs touch

2. category of isolation precautions

what are 4 key points regarding PPE

1. don before contact with patient, generally before entering room

2. use carefully (don't spread contamination)

3. remove + discard carefully, either at doorway/immediately outside patient room; remove respirator outside room

4. immediately perform hand hygiene

what is the 4 step SEQUENCE for DONNING PPE

1. gown

2. mask/respirator

3. goggles/face shield

4. gloves

what is considered the CONTAMINATED AREAS of PPE

outside front

what are CONTAMINATED PPE AREAS

areas of PPE that have/are likely to have been in contact with body sites, materials or environmental surfaces where infectious organism may reside

what is considered the CLEAN AREAS of PPE

inside, outside back, ties on head + back

what are CLEAN PPE AREAS

areas of PPE that are not likely to have been in contact with infectious organisms

what is the 4 step SEQUENCE of REMOVING PPE

1. gloves

2. face shield/goggles

3. gown

4. mask/respirator

what do STANDARD ISOLATION PRECAUTIONS assume

blood + body fluids of any patient could be infectious

what do STANDARD ISOLATION PRECAUTIONS recommend

PPE + other infection control practices to prevent transmission in any healthcare setting

how are decisions about PPE use determined by regarding STANDARD ISOLATION PRECAUTIONS

type of clinical interaction with patient

what is the STANDARD ISOLATION PRECAUTIONS for GLOVES

use when touching:

- blood

- body fluids

- secretions

- excretions

- contaminated items

- mucus membranes + non-intact skin

what is the STANDARD ISOLATION PRECAUTIONS for GOWNS

use during procedures + patient care activities when contact of clothing/exposed skin with blood/body fluids, secretions or excretions is anticipated

what is the STANDARD ISOLATION PRECAUTIONS for MASK + GOGGLES/FACE SHIELD

use during patient care activities likely to generate splashes/sprays of blood, body fluids, secretions or excretions

what type of PPE is used when GIVING a BED BATH

none

what type of PPE is used when SUCTIONING ORAL SECRETIONS

gloves + mask/goggles or face shield

(sometimes gown)

what type of PPE is used when TRANSPORTING a PATIENT in a WHEELCHAIR

none

what type of PPE is used when RESPONDING to an EMERGENCY where BLOOD is SPURTING (4)

1. gloves

2. fluid-resistant gown

3. mask/goggles

4. face shield

what type of PPE is used when DRAWING BLOOD

gloves

what type of PPE is used when CLEANING an INCONTINENT PATIENT w/ DIARRHEA

gloves w/wo gown

what type of PPE is used when TAKING VITALS

none

what are 3 types of EXPANDED PRECAUTIONS

1. contact precautions

2. droplet precautions

3. airborne infection isolation

what is the PPE requirement for CONTACT PRECAUTIONS

GOWN + GLOVES for contact with patient/environment of care

what is the PPE requirement for DROPLET PRECAUTIONS

SURGICAL MASKS within 3 feet of patient

what is the PPE requirement for AIRBORNE INFECTION ISOLATION

PARTICULATE RESPIRATOR + negative pressure isolation room

what is required for both STANDARD + EXPANDED PRECAUTIONS

hand hygiene

when should HAND HYGIENE be performed

immediately after removing PPE + between patient contacts

what should be used when WASHING HANDS

wash hands thoroughly with soap + water/use alcohol-based hand rub