Personal Protective Equipment (PPE) and Precautions

Personal Protective Equipment (PPE)

  • PPE is used to protect ourselves and our residents from infection.

Types of PPE:

  • Gown
  • Mask/N95
  • Gloves
  • Goggles/Face Shield

Precautions & PPE

Contact Precautions
  • Signs on the Door: Alerting staff and visitors to necessary precautions.
  • Hand Hygiene: Clean hands before entering and when leaving the room, according to Standard Precautions.
  • Gloves:
    • Don gloves upon entry into the room or cubicle.
    • Wear gloves when touching the patient and surfaces in close proximity to the patient.
    • Remove gloves before exiting the patient room.
  • Gowns:
    • Don gown upon entry into the room.
    • Remove gown and observe hand hygiene before exiting the patient-care environment.
  • Patient Transport:
    • Limit transport of patients to medically necessary purposes.
    • Ensure that infected or colonized areas of the patient's body are contained and covered.
    • Remove and dispose of contaminated PPE and perform hand hygiene prior to transporting patients on Contact Precautions.
    • Don clean PPE to handle the patient at the transport destination.
  • Patient-Care Equipment: Use disposable or patient-dedicated equipment or implement disinfection protocols.
Enhanced Barrier Precautions
  • Hand Hygiene: Clean hands before entering and when leaving the room.
  • Providers and Staff:
    • Wear gloves and a gown for High-Contact Resident Care Activities, including:
      • Dressing
      • Bathing/Showering
      • Transferring
      • Changing Linens
      • Providing Hygiene
      • Changing brief or assisting with toileting
      • Device care (central line, urinary catheter, feeding tube)
      • Wound Care (any skin opening requiring a dressing)
    • Do not wear the same gown and gloves for the care of more than one person.
Droplet Precautions
  • Mask: Ensure eyes, nose, and mouth are fully covered before room entry.
  • Remove face protection: before room exit.
Potentially Infectious Material (PIM)
  • Blood
  • Urine
  • Bowel movement
  • Other secretions
  • "Assume everyone is infectious"
Universal Precautions
  • Wear gloves when providing care for which you may come in contact with PIM.
  • Wearing gloves at all times can make people feel “diseased.”
Contact Precautions protect from:
  • Bacteria
  • Viruses
  • Parasites
  • Any infectious agent that would be carried on our clothing or skin.
  • Examples:
    • MRSA
    • C-Diff
    • Pediculosis

Droplet Precautions

  • Mask
  • Gloves
  • Gown
  • Examples:
    • COVID
    • RSV
  • Portal of Exit: Mouth/Nose
  • Method of Transmission: Sneezing/Coughing

Airborne Precautions

  • Differ from Droplet
  • These diseases can be life threatening for immunocompromised residents & hard to combat as it lives in the AIR we breathe.
  • Examples:
    • Tuberculosis
    • Pertussis (Whooping Cough)
  • Immunocompromised: Lowered immunity due to illness, cancer, etc. More easy to become sick.
  • PPE:
    • Gown
    • Gloves
    • N95 Mask
  • Isolate if possible

Airborne - Isolation

  • Can we force a resident with an airborne illness to stay in their room? NO!
  • How to protect others?
    • We cannot restrain a resident to their room…. However, we can…ENCOURAGE
    • Note: it is not in the CNA scope of practice to “educate” the resident

Bloodborne Precautions

  • HIV/AIDS/Hep-B/Hep-C
  • Goggles/Face Shield
  • Gown
  • Gloves
  • Mask
  • Hep: Hepatitis

Order of Operations - Placing PPE

  • Gown → Mask → Gloves
  • Think of the goal - To keep “clean” from touching “dirty”
    • Dirty: Front of scrubs, Mouth/Ears
    • Clean: Fresh Gloves, Outside of Gown
  • To prevent cross-contamination
    • Do you want to touch your clean gloves to your face on accident when placing a mask?
    • Gown on/off first ALWAYS
  • crosscontamination: bacteria is accidentally transferred to a clean surface/body

Order of Operations - Removing PPE

  • Gown → Gloves → Mask
  • Clean: Inside of gown, Bare hands, Behind head
  • Dirty: Outside of gown, Gloves, Mask
  • Think: What do we get on our PPE during cares?

Disposing of PPE

  • You should NEVER wear gloves in the hall.
  • Biohazardous Waste:
    • Bio: Life
    • Hazardous: May cause harm
  • PPE should be placed in a RED biohazard container BEFORE leaving the room.