Infection Control: New York State Mandatory Training

Chapter Four - Element IV

Chapter 1: Element I

Chapter 2: Element II

Chapter 3: Element III

Chapter 4: Element IV
Introduction
Types of PPE
Key Points, Sequence,
Safety

Chapter 5: Element V

Chapter 6: Element VI

Chapter 7: Conclusion

Resources

References

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Types of PPE

Types of PPE:

  • 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 the eyes
  • Face shields - protect face, mouth, nose and eyes

Gloves

Gloves are used in patient care situations as well as for environmental services. They are made of vinyl, latex, nitrile and other materials. They are available in both sterile and non-sterile forms; some are made for single use, others are reusable. Healthcare workers sometimes wear a single pair of gloves; sometimes double gloving is utilized (CDC, 2004a).

The procedure for donning gloves is:

  • Select correct type and size.
  • Insert hands into gloves.
  • Extend gloves over isolation gown cuffs.

Do's and Don'ts of Glove Use (CDC, 2004a):

  • Work from "clean" to "dirty"
  • 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 needed during patient care.
  • Change gloves
    • During use if torn or heavily soiled (even when caring for the same patient).
    • After use on each patient.
  • Discard in appropriate receptacle
    • Never wash or reuse disposable gloves.

The procedure for removing gloves is:

  • Grab outside edge near wrist;
  • Peel away from hand, turning glove inside out;
  • Hold in opposite gloved hand;
  • Slide ungloved finger under the wrist of the remaining glove;
  • Peel off from inside, creating a bag for both gloves;
  • Discard.

Gowns and Aprons

Gowns and aprons can be made of natural materials or synthetic materials; they can be disposable or reusable; the level of fluid resistance; sterile or clean.

The procedure for donning a gown is:

  • Select appropriate type and size;
  • Opening is in the back;
  • Secure at neck and waist;
  • If gown is too small, wear 2 gowns:
    • Gown #1 ties in front.
    • Gown #2 ties in back.

The procedure for removing a gown is:

  • Unfasten ties;
  • Peel gown away from neck and shoulder;
  • Turn contaminated outside to the inside;
  • Fold or roll into a bundle;
  • Discard in appropriate receptacle.

Face Protection

Masks protect the nose and mouth; they should fully cover the nose and mouth and prevent fluid penetration.

The procedure for applying a mask is:

  • Pace over nose, mouth and chin;
  • Fit flexible nose piece over nose bridge;
  • Secure on head with ties or elastic;
  • Adjust to fit.

For removal of a mask, use this procedure:

  • Untie the bottom tie, then untie the top tie;
  • Remove from face;
  • Discard.

Goggles protect the eyes; they should fit snuggly over and around the eyes; personal eyeglasses cannot be substituted for goggles; antifog feature improves clarity.

Face shields protect the face, nose, eyes, mouth and eyes; they should cover the forehead, extend below the chin and wrap around side of face.

The procedure for donning eye and face protection is:

  • Position goggles over eyes and secure the head using the earpieces or headband.
  • Position face shield over face and secure on brow with headband.
  • Adjust to fit comfortably.

The procedure for removing goggles or face shields is:

  • Grasp ear or head pieces with ungloved hand (see sequence of removing PPE later in this section of the course);
  • Lift away from face;
  • Place in designated receptacle for disposal or reprossessing.

Respiratory Protection

Purpose is to protect workers from inhalation of infectious aerosols (e.g. Mycobaterium tuberculosis).

Types of respiratory PPE include:

  • Particulate respirators,
  • Half- and full-face elastomeric respirators,
  • Powered air purifying respirators (PAPR).

Elements of a Respiratory Protection Program are:

  • Medical evaluation,
  • Fit testing,
  • Training,
  • Fit checking before use.

The procedure for donning a particulate respirator is:

  • Select a fit tested respirator;
  • Place over nose, mouth and chin;
  • Fit flexible nose piece over bridge of nose;
  • Secure on head with elastic;
  • Adjust to fit;
  • Perform a fit check:
    • Inhale - respirator should collapse.
    • Exhale - check for leakage around face.

Removing a particulate respirator entails the following procedure:

  • Lift the bottom elastic over your head first;
  • Then lift the top elastic;
  • Discard.

Continue on to Key Points, Sequence, Safety