standard precautions and ppe

STANDARD STANDARD PRECAUTIONS AND PRECAUTIONS AND PPEPPE

Standard PrecautionsStandard Precautions Previously called Universal PrecautionsPreviously called Universal Precautions Assumes blood and body fluid of ANY Assumes blood and body fluid of ANY

patient could be infectiouspatient could be infectious Recommends PPE and other infection Recommends PPE and other infection

control practices to prevent control practices to prevent transmission in any healthcare settingtransmission in any healthcare setting

Decisions about PPE use determined Decisions about PPE use determined by type of clinical interaction with patientby type of clinical interaction with patient

PPE Use in Healthcare Settings

Personal Protective Personal Protective Equipment Equipment DefinitionDefinition

““specialized clothing or equipment worn specialized clothing or equipment worn by an employee for protection against by an employee for protection against infectious materials” (OSHA)infectious materials” (OSHA)


Regulations and Regulations and Recommendations for Recommendations for PPEPPE

OSHA issues workplace health and safety OSHA issues workplace health and safety regulations. Regarding PPE, employers must:regulations. Regarding PPE, employers must: Provide appropriate PPE for employeesProvide appropriate PPE for employees Ensure that PPE is disposed or reusable PPE is Ensure that PPE is disposed or reusable PPE is

cleaned, laundered, repaired and stored after usecleaned, laundered, repaired and stored after use OSHA also specifies circumstances for which OSHA also specifies circumstances for which

PPE is indicatedPPE is indicated CDC recommends when, what and how to use CDC recommends when, what and how to use

PPEPPEPPE Use in Healthcare Settings

Types of PPE Used in Types of PPE Used in Healthcare SettingsHealthcare Settings

Gloves – protect handsGloves – protect hands Gowns/aprons – protect skin and/or clothing Gowns/aprons – protect skin and/or clothing Masks and respirators– protect mouth/nose Masks and respirators– protect mouth/nose

Respirators – protect respiratory tract from Respirators – protect respiratory tract from airborne infectious agentsairborne infectious agents

Goggles – protect eyesGoggles – protect eyes Face shields – protect face, mouth, nose, and Face shields – protect face, mouth, nose, and

eyeseyesPPE Use in Healthcare Settings

Factors Influencing PPE Factors Influencing PPE SelectionSelection

Type of exposure anticipatedType of exposure anticipated Splash/spray versus touchSplash/spray versus touch Category of isolation precautionsCategory of isolation precautions

Durability and appropriateness for the Durability and appropriateness for the tasktask

FitFit


GlovesGloves

Purpose – patient care, environmental Purpose – patient care, environmental services, otherservices, other

Glove material – vinyl, latex, nitrile, Glove material – vinyl, latex, nitrile, otherother

Sterile or nonsterileSterile or nonsterile One or two pairOne or two pair Single use or reusableSingle use or reusable


Do’s and Don’ts of Glove Do’s and Don’ts of Glove UseUse

Change glovesChange gloves During use if torn and when heavily soiled During use if torn and when heavily soiled

(even during use on the same patient)(even during use on the same patient) After use on each patientAfter use on each patient

Discard in appropriate receptacleDiscard in appropriate receptacle Never wash or reuse disposable glovesNever wash or reuse disposable gloves


Gowns or ApronsGowns or Aprons

Purpose of usePurpose of use Material –Material –

Natural or man-madeNatural or man-made Reusable or disposableReusable or disposable Resistance to fluid penetrationResistance to fluid penetration

Clean or sterileClean or sterile


Face ProtectionFace Protection Masks – protect nose and mouthMasks – protect nose and mouth

Should fully cover nose and mouth and Should fully cover nose and mouth and prevent fluid penetrationprevent fluid penetration

Goggles – protect eyesGoggles – protect eyes Should fit snuggly over and around eyesShould fit snuggly over and around eyes Personal glasses not a substitute for Personal glasses not a substitute for

gogglesgoggles Anti-fog feature improves clarityAnti-fog feature improves clarity


Key Points About PPEKey Points About PPE Don before contact with the patient, Don before contact with the patient,

generally before entering the roomgenerally before entering the room Use carefully – don’t spread Use carefully – don’t spread

contaminationcontamination Remove and discard carefully, either at Remove and discard carefully, either at

the doorway or immediately outside the doorway or immediately outside patient room; remove respirator outside patient room; remove respirator outside roomroom

Immediately perform hand hygieneImmediately perform hand hygienePPE Use in Healthcare Settings

Sequence* for Putting on Sequence* for Putting on PPEPPE

Gown firstGown first Mask or respiratorMask or respirator Goggles or face shieldGoggles or face shield GlovesGloves

*Combination of PPE will affect sequence – be practical


How to Put on a GownHow to Put on a Gown

Select appropriate type and sizeSelect appropriate type and size Opening is in the backOpening is in the back Secure at neck and waistSecure at neck and waist If gown is too small, use two gownsIf gown is too small, use two gowns

Gown #1 ties in frontGown #1 ties in front Gown #2 ties in backGown #2 ties in back


How to Put on a MaskHow to Put on a Mask Place over nose, mouth and chinPlace over nose, mouth and chin Fit flexible nose piece over nose bridgeFit flexible nose piece over nose bridge Secure on head with ties or elasticSecure on head with ties or elastic Adjust to fitAdjust to fit


How to Put on Eye and How to Put on Eye and Face ProtectionFace Protection Position goggles over Position goggles over

eyes and secure to the eyes and secure to the head using the ear pieces head using the ear pieces or headbandor headband

Position face shield over Position face shield over face and secure on brow face and secure on brow with headbandwith headband

Adjust to fit comfortablyAdjust to fit comfortablyPPE Use in Healthcare Settings

How to Put on GlovesHow to Put on Gloves Put on gloves lastPut on gloves last Select correct type and sizeSelect correct type and size Insert hands into glovesInsert hands into gloves Extend gloves over isolation gown cuffsExtend gloves over isolation gown cuffs


How to Safely Use PPEHow to Safely Use PPE

Keep gloved hands away from faceKeep gloved hands away from face Avoid touching or adjusting other PPEAvoid touching or adjusting other PPE Remove gloves if they become torn; Remove gloves if they become torn;

perform hand hygiene before donning perform hand hygiene before donning new glovesnew gloves

Limit surfaces and items touchedLimit surfaces and items touched


Sequence for Removing Sequence for Removing PPEPPE GlovesGloves Face shield or gogglesFace shield or goggles GownGown Mask or respiratorMask or respirator


Where to Remove PPEWhere to Remove PPE

At doorway, before leaving patient room At doorway, before leaving patient room or in anteroom*or in anteroom*

Remove respirator outside room, after Remove respirator outside room, after door has been closed*door has been closed*

* Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub


What Type of PPE Would What Type of PPE Would YouYou Wear? Wear?

Giving a bed bath?Giving a bed bath? Suctioning oral Suctioning oral

secretions?secretions? Transporting a patient Transporting a patient

in a wheel chair?in a wheel chair? Responding to an Responding to an

emergency where emergency where blood is spurting?blood is spurting?

Drawing blood from a Drawing blood from a vein?vein?

Cleaning an incontinent Cleaning an incontinent patient with diarrhea?patient with diarrhea?

Irrigating a wound?Irrigating a wound? Taking vital signs?Taking vital signs?

What Type of PPE Would What Type of PPE Would YouYou Wear? Wear? Giving a bed bath?Giving a bed bath?

GlovesGloves Suctioning oral secretions?Suctioning oral secretions?

Gloves and Gloves and mask/goggles or a face mask/goggles or a face shield – sometimes gownshield – sometimes gown

Transporting a patient in a Transporting a patient in a wheel chair?wheel chair?

Generally none requiredGenerally none required Responding to an Responding to an

emergency where blood is emergency where blood is spurting?spurting?

Gloves, fluid-resistant Gloves, fluid-resistant gown, mask/goggles or a gown, mask/goggles or a face shieldface shield

Drawing blood from a vein?Drawing blood from a vein? GlovesGloves

Cleaning an incontinent Cleaning an incontinent patient with diarrhea?patient with diarrhea?

Gloves w/ gownGloves w/ gown Irrigating a wound?Irrigating a wound?

Gloves, gown, Gloves, gown, mask/goggles or a face mask/goggles or a face shieldshield

Taking vital signs?Taking vital signs? Generally noneGenerally none

PPE Use in Healthcare PPE Use in Healthcare Settings:Settings:Final ThoughtsFinal Thoughts PPE is available to protect you from PPE is available to protect you from

exposure to infectious agents in the exposure to infectious agents in the healthcare workplacehealthcare workplace

Know what type of PPE is necessary for Know what type of PPE is necessary for the duties you perform and use it the duties you perform and use it correctlycorrectly

standard precautions and ppe

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