Infection Contol, PPE, and Donning & Doffing

Infection Control

1. Standard Precautions

   • Hand Hygiene:

     • Wash hands with soap and water for at least 20 seconds.

     • Use alcohol-based hand sanitizer if soap and water are not available.

   • Use of Personal Protective Equipment (PPE):

     • Gloves: Wear when touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes, or non-intact skin.

     • Gowns: Wear during procedures and patient care activities when contact of clothing/exposed skin with blood, body fluids, secretions, or excretions is anticipated.

     • Masks and Eye Protection: Wear a mask and eye protection during procedures that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.

   • Respiratory Hygiene/Cough Etiquette:

     • Cover mouth and nose with a tissue when coughing or sneezing.

     • Use a surgical mask if coughing or sneezing persistently.

     • Dispose of used tissues in a no-touch receptacle.

     • Perform hand hygiene after contact with respiratory secretions.

   • Safe Injection Practices:

     • Use aseptic technique when preparing and administering medications.

     • Use single-dose vials whenever possible.

     • Use a new needle and syringe for each injection.

   • Cleaning and Disinfection:

     • Clean and disinfect environmental surfaces regularly.

     • Use appropriate disinfectants approved by regulatory agencies.

2. Transmission-Based Precautions

   • Airborne Precautions:

     • Use when pathogens are transmitted through the air (e.g., tuberculosis, measles, chickenpox).

     • Wear a NIOSH-approved N95 respirator when entering the room.

     • Place patient in an Airborne Infection Isolation Room (AIIR) with negative pressure.

   • Droplet Precautions:

     • Use when pathogens are transmitted through close respiratory or mucous membrane contact (e.g., influenza, pertussis, mumps).

     • Wear a surgical mask when within 6 feet of the patient.

     • Place patient in a single room if possible.

   • Contact Precautions:

     • Use when pathogens are transmitted by direct contact or indirect contact (e.g., MRSA, VRE, C. difficile).

     • Wear gloves and gown upon entry into the patient's room.

     • Remove gloves and gown before leaving the patient's room.

     • Ensure dedicated equipment is used for the patient (e.g., stethoscope, blood pressure cuff).

Personal Protective Equipment (PPE)

1. Types of PPE

   • Gloves:

     • Protect hands from contamination.

     • Types include: sterile, non-sterile, examination, surgical, utility.

     • Must be changed between patients and after contact with infectious material.

   • Gowns:

     • Protect skin and clothing during procedures.

     • Types include: disposable and reusable.

     • Select appropriate gown based on the level of anticipated exposure.

   • Masks:

     • Protect against splashes and sprays, and some can filter airborne particles.

     • Types include: surgical masks, N95 respirators.

     • N95 respirators require fit-testing to ensure a proper seal.

   • Eye Protection:

     • Protect eyes from splashes and sprays.

     • Types include: goggles, face shields.

     • Ensure proper fit and clean regularly.

2. Donning and Doffing PPE

   • Donning (Putting On):

     1. Hand hygiene.

     2. Gown.

     3. Mask.

     4. Eye protection.

     5. Gloves.

   • Doffing (Taking Off):

     1. Gloves.

     2. Eye protection.

     3. Gown.

     4. Mask.

     5. Hand hygiene.

   • Important Considerations:

     • Perform hand hygiene immediately after removing PPE.

     • Remove PPE carefully to avoid self-contamination.

     • Dispose of PPE properly in designated containers.

3. Proper Use and Maintenance

   • Inspection:

     • Inspect PPE for damage or defects before use.

     • Do not use if compromised.

   • Storage:

     • Store PPE in a clean, dry location.

     • Ensure easy access for healthcare workers.

   • Training:

     • Provide regular training on the proper use of PPE.

     • Include donning and doffing procedures.

     • Emphasize the importance of adherence to guidelines.

Infection Control

1. Standard Precautions

   • Hand Hygiene:

     • Wash hands with soap and water for at least 20 seconds.

     • Use alcohol-based hand sanitizer if soap and water are not available.

   • Use of Personal Protective Equipment (PPE):

     • Gloves: Wear when touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes, or non-intact skin.

     • Gowns: Wear during procedures and patient care activities when contact of clothing/exposed skin with blood, body fluids, secretions, or excretions is anticipated.

     • Masks and Eye Protection: Wear a mask and eye protection during procedures that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.

   • Respiratory Hygiene/Cough Etiquette:

     • Cover mouth and nose with a tissue when coughing or sneezing.

     • Use a surgical mask if coughing or sneezing persistently.

     • Dispose of used tissues in a no-touch receptacle.

     • Perform hand hygiene after contact with respiratory secretions.

   • Safe Injection Practices:

     • Use aseptic technique when preparing and administering medications.

     • Use single-dose vials whenever possible.

     • Use a new needle and syringe for each injection.

   • Cleaning and Disinfection:

     • Clean and disinfect environmental surfaces regularly.

     • Use appropriate disinfectants approved by regulatory agencies.

2. Transmission-Based Precautions

   • Airborne Precautions:

     • Use when pathogens are transmitted through the air (e.g., tuberculosis, measles, chickenpox).

     • Wear a NIOSH-approved N95 respirator when entering the room.

     • Place patient in an Airborne Infection Isolation Room (AIIR) with negative pressure.

   • Droplet Precautions:

     • Use when pathogens are transmitted through close respiratory or mucous membrane contact (e.g., influenza, pertussis, mumps).

     • Wear a surgical mask when within 6 feet of the patient.

     • Place patient in a single room if possible.

   • Contact Precautions:

     • Use when pathogens are transmitted by direct contact or indirect contact (e.g., MRSA, VRE, C. difficile).

     • Wear gloves and gown upon entry into the patient's room.

     • Remove gloves and gown before leaving the patient's room.

     • Ensure dedicated equipment is used for the patient (e.g., stethoscope, blood pressure cuff).

Personal Protective Equipment (PPE)

1. Types of PPE

   • Gloves:

     • Protect hands from contamination.

     • Types include: sterile, non-sterile, examination, surgical, utility.

     • Must be changed between patients and after contact with infectious material.

   • Gowns:

     • Protect skin and clothing during procedures.

     • Types include: disposable and reusable.

     • Select appropriate gown based on the level of anticipated exposure.

   • Masks:

     • Protect against splashes and sprays, and some can filter airborne particles.

     • Types include: surgical masks, N95 respirators.

     • N95 respirators require fit-testing to ensure a proper seal.

   • Eye Protection:

     • Protect eyes from splashes and sprays.

     • Types include: goggles, face shields.

     • Ensure proper fit and clean regularly.

2. Donning and Doffing PPE

   • Donning (Putting On):

     1. Hand hygiene.

     2. Gown.

     3. Mask.

     4. Eye protection.

     5. Gloves.

        • Donning Gloves

          1. Wash and dry hands, or use hand sanitizer.

          2. Open the glove package carefully, touching only the outer edges.

          3. Insert your hand into the glove, ensuring a snug fit.

          4. If wearing a gown, make sure the gloves overlap the gown cuffs.

   • Doffing (Taking Off):

     1. Gloves.

     2. Eye protection.

     3. Gown.

     4. Mask.

     5. Hand hygiene.

        • Doffing Gloves

          1. Pinch the outside of one glove near the wrist.

          2. Peel the glove away from your body, turning it inside out.

          3. Hold the removed glove in your gloved hand.

          4. Slide fingers of your ungloved hand under the wrist of the remaining glove.

          5. Peel off the second glove, turning it inside out and encasing the first glove.

          6. Dispose of the gloves in a designated waste container.

        • Doffing PPE

          1. Remove gloves first to avoid contamination from other PPE.

          2. Remove eye protection. Handle by the frames or ear pieces.

          3. Remove gown. Unfasten ties and pull away from the neck and shoulders, turning it inside out.

          4. Remove mask. Untie or break the elastic straps, avoid touching the front of the mask.

          5. Perform hand hygiene immediately after removing all PPE.

   • Important Considerations:

     • Perform hand hygiene immediately after removing PPE.

     • Remove PPE carefully to avoid self-contamination.

     • Dispose of PPE properly in designated containers.