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Personal Protective Equipment(PPE)
Learning Objectives
At the end of this module, participants will be
able to: Define & list personal protective equipment (PPE) that should be used routinely by lab workers Provide information on the selection and use of PPE in healthcare settings Practice how to safely Don and Doff PPE Introduction
The hazard control methods at the top of graphic are potentially more effective and protective than those at the bottom. Introduction cont’d… What is Personal Protective Equipment?
Definition: “Specialized clothing or
equipment worn by an employee for protection against infectious materials” (OSHA) Why Do We Use PPE? To provide barriers against skin, mucous membrane, and respiratory tract exposure to infectious agents To reduce the likelihood of exposure to infectious materials When to Use PPE? Standard Precautions
Assumes blood and body fluid of ANY patient could be
infectious Recommends PPE and other infection control practices to prevent transmission in any healthcare setting Decisions about PPE use determined by type of clinical interaction with patient Class Activity Identifying Types of PPE to Protect Against Exposure by Different Routes Inhalation Ingestion
Absorption
Percutaneous • Types of PPE Used in Healthcare Settings? Types of PPE Used in Healthcare Settings Gloves – protect hands Gowns/aprons – protect skin and/or clothing Masks and respirators– protect mouth/nose • Respirators – protect respiratory tract from airborne infectious agents Goggles – protect eyes Face shields – protect face, mouth, nose, and eyes Others Gloves Use: lab activities, Patient care, environmental services, others Materials of glove can be vinyl, latex or nitrile Sterile or non-sterile Can be applied in one or two pair based on the procedure and hazardous level of materials in contact Single use or reusable Gloves Cont’d Do’s and Don’ts of Glove Use Do’s Work from “clean to dirty” Limit opportunities for “touch contamination” Change gloves • During use if torn and when heavily soiled (even during use on the same patient) • After use on each patient Gloves Cont’d Don’ts Touch your face or adjust PPE with contaminated gloves Touch environmental surfaces except as necessary during patient care Wear outside the lab
Touch personal items
Gowns / Aprons
Materials • Natural or man-made • Reusable or disposable • Resistance to fluid penetration Clean or sterile Types Front closing vs. rear closing Liquid proof vs. resistant Face Protection (Masks )
Masks – Protect nose and mouth
• Should fully cover nose and mouth and
Protect against droplets and aerosols
Note ; expand slide to provide information on mask
purpose and fit. Respiratory Protection Respirators filter the air you breathe to help protect you from microorganisms including bacteria and many viruses. Types of respirators include: • Particulate respirators (Disposable Respirators) (includes N95, P100) • Powered Air Purifying Respirator (PAPR) • Self-Contained Breathing Apparatus (SCBA) Respirators Masks • Type of masks – Surgical – Negative pressure respirators • N95 & P100 • Half or full face respirator – Positive pressure respirator • PAPR Surgical mask N 95 Air Purifying Respirators Non-powered (Negative Pressure)
Powered (Positive Pressure or PAPR)
R-SeriesTM PAPR System Elements of a Respiratory Protection Program
Medical evaluation
Fit testing and checking before use
Training Goggles Goggles – Protect eyes
• Should fit snuggly over and around eyes
• Personal glasses not a substitute for goggles
• Antifog feature improves clarity
Face Shield
Intended to protect the entire face or portions
thereof. Can provide protection against UV radiation and splashes. Considered secondary protection and must be used in conjunction with safety goggles or glasses to provide adequate protection. Shoe and Head Covers Shoe covers
• Wear shoe covers to provide a barrier against
possible exposure and to minimize contamination. Head covers
• Wear head covers to protect the hair and scalp
from possible exposure & minimize contamination. Factors Influencing PPE Selection Agent & activities conducted Type of exposure anticipated • Splash/spray vs. touch Durability and appropriateness for the task Fit Based on risk assessment Key Points About PPE Apply before contact with the patient, generally before entering the room Apply before entering the lab & discard before leaving Use carefully – don’t spread contamination Remove and discard carefully Immediately perform hand washing after PPE removal Sequence for Donning & Doffing PPE Can vary depending on the type of PPE used and activities performed
Should be documented in a written SOP
Staff should follow & be trained on the SOP
Regularly reviewed & revised
How to Don a Gown Select appropriate type and size Preferably opening is in the back, but based on type of gown available Secure at neck and waist If gown is too small, use two gowns • Gown #1 ties in front • Gown #2 ties in back How to Don a Gown Cont’d… • If the gown is with front opening, make sure to close the gown with appropriate locker/zipper • Make sure that the end of sleeves are tight enough with our hand • Never folded up the sleeve and let the hand uncover. How to Don a Mask Place over nose, mouth and chin
Fit flexible nose piece over nose bridge
Secure on head with ties or elastic
Adjust to fit How to Don a Particulate Respirator Its disposable Respirators which includes N95, N99 or P100 Select a fit tested respirator Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with elastic Adjust to fit and perform a fit check – • Inhale – respirator should collapse • Exhale – check for leakage around face How to Don Eye and Face Protection Position goggles over eyes and secure to the head using the ear pieces or headband
Position face shield over face and
secure on brow with headband
Adjust to fit comfortably
How to Don Gloves Select correct type and size
Check for any damage
Insert hands into gloves
Extend gloves over sleeves gown
How to Safely Doff/Remove PPE “Contaminated” and “Clean” Areas of PPE Contaminated – outside front • Areas of PPE that have or are likely to have been in contact with body sites, materials, or environmental surfaces where the infectious organism may reside Clean – inside, outside back, ties on head and back • Areas of PPE that are not likely to have been in contact with the infectious organism Where to Remove PPE? At doorway, before leaving Laboratory/patient room or in anteroom*
Remove respirator outside room, after door
has been closed* * Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub How to Remove Gloves Grasp outside edge near wrist
Peel away from hand, turning glove inside-out
Hold in opposite gloved hand
How to Remove Gloves Cont’d Slide ungloved finger under the wrist of the remaining glove
Peel off from inside, creating a bag for both
gloves Discard appropriately inside the biohazard bag Remove Goggles or Face Shield Grasp ear or head pieces with ungloved hands
Lift away from face
Place in designated receptacle for
decontamination or disposal Removing Gown Unfasten ties Peel gown away from neck and shoulder Turn contaminated outside toward the inside Fold or roll into a bundle Discard(only for disposable gown) Removing a Mask Untie the bottom, then top tie
Remove from face
Discard inside to biohazard
bag Removing a particulate Respirator
Lift the bottom
elastic over your head first Then lift off the top elastic Discard Hand Hygiene Perform hand hygiene immediately after removing PPE. • If hands become visibly contaminated during PPE removal, wash hands before continuing to remove PPE Wash hands with soap and water use an alcohol-based hand rub when soap & water not available What Type of PPE Would You Wear? Inoculating sputum for Drawing blood from a culturing TB vein? Suctioning oral Cleaning lab work secretions? bench Transporting lab Login in registration log specimen using cold boo or I Occurrence log box book Responding to an Posting safety signage? emergency where blood is spurting? What Type of PPE Would You Wear? Inoculating sputum for Drawing blood from a culturing TB vein? • Gloves, Gown and N95 mask • Gloves, Gown Suctioning oral secretions? Cleaning lab work • Gloves and mask/goggles or a face bench shield – sometimes gown • Gloves & Gown Transporting lab specimen Login in registration log using cold box book or Occurrence log • Generally none required book Responding to an emergency • Generally none where blood is spurting? Posting safety signage? • Gloves, fluid-resistant gown, mask/goggles or a face shield • Generally none Summary PPE serves to protect you from exposure to infectious agents, the patient, and minimize contamination in the healthcare / lab workplace Use all Available Equipment! • Protective clothing • Gloves, Goggles, • Respirators ( N95….) Know what type of PPE is necessary for the duties you perform and use it correctly All decisions related to PPE should be based on a comprehensive risk assessment
