PROTEC

TIVE
EQUIPM
ENT
Prepared by: Prof. Elizabeth D. CRUZ,
RN, MAN
 PERSONAL PROTECTIVE EQUIPMENT
 Are various items worn to protect the healthcare worker
from body fluids and infectious diseases when caring for ill
patients.
 It's important to remember that all body fluids should be
treated as a potential infectious agent even if the patient
doesn't have a confirmed diagnosis.
 Is designed to help protect an individual’s health and safety
particularly among frontline health care workers, as they
often come into contact with sick people.
 Prevents contact with an infectious agent by creating a
barrier between the potentially infectious material and the
 PERSONAL PROTECTIVE EQUIPMENT
 refers to specialized clothing or equipment worn by an
employee for protection against infectious materials.
 PPE is used in healthcare settings to improve personnel
safety in the healthcare environment through the
appropriate use of PPE (CDC, 2004a).
 This equipment includes clean (unsterile) and sterile
gloves, impervious gowns/aprons, surgical and high-
efficiency particulate air (HEPA) masks, N95 disposable
masks, face shields, and protective eyewear/goggles.
 GUIDELINES FOR EFFECTIVE USE OF
1. Put on PPE before contact with PPE
the patient, preferably before entering
the patient’s room.
2. Choose appropriate PPE based on the type of exposure anticipated and
category of isolation precautions.
3. When wearing gloves, work from ‘clean’ areas to ‘dirty’ ones.
4. Touch as few surfaces and items with your PPE as possible.
5. Avoid touching or adjusting other PPE.
6. Keep gloved hands away from your face.
7. If gloves become torn or heavily soiled, remove and replace. Perform
hand hygiene before putting on the new gloves.
8. Personal glasses are not a substitute for goggles.
 Hand Hygiene

1. Most basic and important step of to prevent spread of

infection.
2. Choices include alcohol-based hand rub or soap and
water.
 Important Point

 Alcohol- based hand rubs are preferred unless the

hands are visibly dirty or exposed to some organisms
because:
a. Alcohol-based hand rubs are more effective in
removing microorganisms.
b. Some alcohol-based hand rubs contain emollients,
which cause less skin irritation and dryness than
soap.
 Hand Hygiene
 Use alcohol-based hand rub for the following if the hands
aren’t visibly soiled:
1. Before and after direct contact with patients.
2. Before applying sterile gloves and inserting an invasive
device, for example a urinary catheter.
3. After contact with wound dressing.
4. When moving from a contaminated area to a clean body site
during patient care.
5. After contact with inanimate objects.
6. After removing gloves
 Hand Hygiene
Wash with plain or antibacterial soap and water for at
least 15 seconds if:
1. Hands visibly dirty.
2. Hands soiled with blood or body fluid.
3. After removing PPE.
4. Before eating, and after using the toilet.
Wash with nonantimicrobial soap and water for at least
15 seconds if:
1. Exposed to spore-forming organisms like Clostridium
difficile or Bacillus anthracis.
 PERSONAL PROTECTIVE EQUIPMENT

01 Surgical masks and 03 Safety gloves (must

respirators be worn to the wrist)

Lab coat or apron Eye or face

(wear it correctly) protection (such as
02 glasses) 04
 Types of PPE Used in Healthcare Settings

1. Gloves – protect hands

2. Gowns/aprons – protect skin and/or
clothing
3. Masks and respirators– protect
mouth/nose
4. Respirators – protect respiratory tract
from airborne infectious agents
5. Goggles – protect eyes
6. Face shields – protect face, mouth,
nose, and eyes
 Factors Influencing PPE Selection

1. Type of exposure anticipated

Splash/spray versus touch
Category of isolation precautions
2. Durability and appropriateness for the
task
3. Fit
 Gloves

1. Purpose – patient care, environmental services,

other
2. Glove material – vinyl, latex, nitrile, other
3. Sterile or nonsterile
4. One or two pair
5. Single use or reusable
 Do’s and Don’ts of Glove Use
1. Work from “clean to dirty”
2. Limit opportunities for “touch contamination” - protect yourself, others, and
the environment

Don’t touch your face or adjust PPE with contaminated gloves

Don’t touch environmental surfaces except as necessary during patient care

3. Change gloves

During use if torn and when heavily soiled (even during use on the same
patient)

After use on each patient

4. Discard in appropriate receptacle
 Gowns or Aprons

1. Purpose of use
2. Material –
Natural or man-made
Reusable or disposable
Resistance to fluid
penetration
3. Clean or sterile
 Face Protection
1. Masks – protect nose and mouth

a. Should fully cover nose and mouth and

prevent fluid penetration
2. Goggles – protect eyes

b. Should fit snuggly over and around eyes

c. Personal glasses not a substitute for

goggles

d. Antifog feature improves clarity

3. Face shields – protect face, nose, mouth, and
eyes
 Respiratory Protection

1. Purpose – protect from inhalation of

infectious aerosols (e.g., Mycobacterium
tuberculosis)
2. PPE types for respiratory protection

a. Particulate respirators

b. Half- or full-face elastomeric

respirators

c. Powered air purifying

respirators (PAPR)
Elements of a Respiratory Protection Program

1. Medical evaluation
2. Fit testing
3. Training
4. Fit checking before use
PPE Use in Healthcare
Settings:
How to Safely Don,
Use, and Remove PPE
 Key Points About PPE

1. Don before contact with the patient, generally before

entering the room
2. Use carefully – don’t spread contamination
3. Remove and discard carefully, either at the doorway
or immediately outside patient room; remove respirator
outside room
4. Immediately perform hand hygiene
 Sequence* for Donning PPE

1. Gown first
2. Mask or respirator
3. Goggles or face shield
4. Gloves
 How to Don a Gown

1. Select appropriate type and size

2. Opening is in the back
3. Secure at neck and waist
4. If gown is too small, use two gowns
a. Gown #1 ties in front
b. Gown #2 ties in back
 How to Don a Mask

1. Place over nose, mouth and chin

2. Fit flexible nose piece over nose bridge
3. Secure on head with ties or elastic
4. Adjust to fit
 How to Don a Particulate Respirator

1. Select a fit tested respirator

2. Place over nose, mouth and chin
3. Fit flexible nose piece over nose bridge
4. Secure on head with elastic
5. Adjust to fit
6. Perform a fit check –
a. Inhale – respirator should collapse
b. Exhale – check for leakage around face
 How to Don Eye and Face Protection
1. Position goggles over eyes and
secure to the head using the ear
pieces or headband
2. Position face shield over face
and secure on brow with headband
3. Adjust to fit comfortably
 How to Don Gloves

1. Don gloves last

2. Select correct type and size
3. Insert hands into gloves
4. Extend gloves over isolation
gown cuffs
 How to Safely Use PPE

1. Keep gloved hands away from face

2. Avoid touching or adjusting other PPE
3. Remove gloves if they become torn; perform hand
hygiene before donning new gloves
4. Limit surfaces and items touched
PPE Use in Healthcare
Settings:
How to Safely Remove
PPE
 Contaminated” and “Clean” Areas of PPE

1. Contaminated – outside front

i. 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
2. Clean – inside, outside back, ties on head and back
i. Areas of PPE that are not likely to have been in contact with the infectious
organism
 Sequence for Removing PPE

1. Gloves
2. Face shield or goggles
3. Gown
4. Mask or respirator
 Where to Remove PPE
1. At doorway, before leaving patient room or in anteroom*
2. Remove respirator outside room, after door has been
closed*

3.* Ensure that hand hygiene facilities

are available at the point needed, e.g.,
sink or alcohol-based hand rub
 How to Remove Gloves (1)

1. Grasp outside edge near wrist

2. Peel away from hand, turning glove inside-
out
3. Hold in opposite gloved hand
 How to Remove Gloves (2)

Slide ungloved finger

under the wrist of the
remaining glove
Peel off from inside,
creating a bag for both
gloves
Discard
 Remove Goggles or Face Shield

1. Grasp ear or head pieces with

ungloved hands
2. Lift away from face
3. Place in designated receptacle for
reprocessing or disposal
 Removing Isolation Gown

1. Unfasten ties
2. Peel gown away from neck
and shoulder
3. Turn contaminated outside
toward the inside
4. Fold or roll into a bundle
5. Discard
 Removing a Mask

1. Untie the bottom, then top, tie

2. Remove from face
3. Discard
 Removing a Particulate Respirator

1. Lift the bottom elastic over your headfirst

2. Then lift off the top elastic
3. Discard
 Hand Hygiene
1. Perform hand hygiene immediately after removing PPE.
a. If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove
PPE
2. Wash hands with soap and water or use an alcohol-based
hand rub

* Ensure that hand hygiene facilities are available at

the point needed, e.g., sink or alcohol-based hand rub
PPE Use in
Healthcare Settings:
When to Use PPE
Standard and Expanded
Isolation Precautions
 Standard Precautions
1. In order to prevent the spread of infections, respiratory hygiene/cough
etiquette should be emphasized and includes:
2. Cover the nose/mouth when coughing or sneezing or cough or sneeze
into your upper sleeve, not your hands.
3. Use tissues to contain respiratory secretions and dispose in the nearest
waste container.
4. Perform hand washing after contacting respiratory secretions and
contaminated objects/materials.
5. Patients with a fever or cough should wear a mask until placed in a
patient care room.

 After room placement, staff wear a mask.

6. Sit at least 3 feet away from others if coughing.
 Standard Precautions

1. Previously called Universal Precautions

2. Assumes blood and body fluid of ANY patient could be
infectious
3. Recommends PPE and other infection control practices
to prevent transmission in any healthcare setting
4. Decisions about PPE use determined by type of clinical
interaction with patient
 PPE for Standard Precautions (1)

1. Gloves – Use when touching blood, body fluids,

secretions, excretions, contaminated items; for touching
mucus membranes and nonintact skin
2. Gowns – Use during procedures and patient care
activities when contact of clothing/ exposed skin with
blood/body fluids, secretions, or excretions is anticipated
 PPE for Standard Precautions (2)

Mask and goggles or a face shield

– Use during patient care activities likely to generate
splashes or sprays of blood, body fluids, secretions, or
excretions
What Type of PPE Would You Wear?
 PPE for Expanded Precautions

1. Expanded Precautions include

a. Contact Precautions
b. Droplet Precautions
c. Airborne Infection Isolation
 Use of PPE for Expanded Precautions

1. Contact Precautions – Gown and gloves for contact

with patient or environment of care (e.g., medical
equipment, environmental surfaces)
i. In some instances, these are required for entering
patient’s environment
2. Droplet Precautions – Surgical masks within 3 feet of
patient
3. Airborne Infection Isolation – Particulate respirator
 Hand Hygiene

1.Required for Standard and Expanded

Precautions
2.Perform…
a. Immediately after removing PPE
b.Between patient contacts
3.Wash hands thoroughly with soap and water or
use alcohol-based hand rub
WE MUST
each DO
OUR part
 PPE Use in Healthcare Settings: Final Thoughts

1.PPE is available to protect you from

exposure to infectious agents in the
healthcare workplace
2.Know what type of PPE is necessary for
the duties you perform and use it correctly
 THANKS!

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