Personal Protective Equipment (PPE)

For the staff listed in “A: Positions that Usually Do Have Occupational Exposure” and “B: Positions that May Have Occupational Exposure” sections of the main page of this Plan, NKY Health will provide, at no cost to the staff, personal protective equipment appropriate for the services provided and accessible on-site at the location of use. 

Examples of protective equipment include: gloves, gowns, face shields or masks, eye protection, mouthpieces, resuscitation bags, and pocket masks or other ventilation devices. 

Personal protective equipment will be considered appropriate only when it does not permit blood or other potentially infectious materials to pass through to reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth or other mucous membranes. Barrier protection should be used when coming in contact with blood and all bodily fluids, whether or not there is visible blood.

NKY Health staff will use the equipment listed and as specified below. In a rare and extraordinary circumstance, staff may decline to use the equipment if, in that particular instance, its use would have prevented the delivery of a service to the patient or would have posed an increased hazard to the safety of the worker or co-worker.

 When staff declines to use the protective equipment, s/he will document the instance in writing the staff's supervisor, her/his designee, or the appropriate Division Director will investigate to determine whether failure to use the equipment was appropriate, and if not, what changes can be instituted to prevent future occurrences.

NKY Health will ensure that protective equipment in the appropriate size is readily accessible at the worksite or is issued directly to staff. Hypoallergenic gloves, glove liners or other similar alternatives will be readily accessible to those employees who are allergic to the gloves normally provided.

NKY Health will clean, launder and dispose of personal protective equipment at no cost to staff.

NKY Health will repair or replace personal protective equipment as needed to maintain its effectiveness, at no cost to staff. 

When a garment is penetrated by blood or other potentially infectious materials, the garment will be removed immediately or as soon as possible thereafter.

All personal protective equipment will be removed prior to leaving the worksite. Home health staff will remove the personal protective equipment prior to leaving the patient’s home.

When personal protective equipment is removed, it will be placed in an appropriately designated area or container for storage, washing, decontamination or disposal.

Gloves will be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous membranes and non-intact skin; when performing vascular access procedures and when handling or touching contaminated items or surfaces.

The gloves will be treated as follows:

• Disposable (single use) gloves, such as surgical or examination gloves will be replaced as soon as practical when contaminated or will be replaced if they are torn punctured or whenever their ability to function as a barrier is compromised.

• Disposable (single use) gloves will not be washed or decontaminated for re-use.

• Utility gloves may be decontaminated for re-use if the integrity of the glove is not compromised; however, they must be discarded if they are cracked, peeling, torn, punctured, exhibit other signs of deterioration or whenever their ability to function as a barrier is compromised.

The following are some guidelines for using gloves:

• Hands must be washed before gloving.

• Health care workers should always wear gloves when:

• Touching blood and bodily fluids.

• Touching mucous membranes.

• Touching non-intact skin of all patients or when the health care worker’s skin is not intact. Health care workers with exudative skin lesions or weeping dermatitis should refrain from direct patient contact or handling patient care equipment until the skin condition resolves.

• Handling items or surfaces soiled by blood or other bloody fluids when processing blood or any bodily fluid specimen.

• Gloves must be changed after contact with each patient and hands must be thoroughly washed with soap and water.

• Change gloves between tasks and procedures on the same patient after contact with materials that may contain a high concentration of microorganisms.

Handwashing:

• Hands or other skin must be immediately and thoroughly washed if contaminated with blood or bodily fluids. Hands must always be washed before and after the examination and before leaving the examination room. Hand washing should be with soap and warm water. Rub hands together using friction creating lather for 15-20 seconds. Rinse and pat dry with disposable towel. Waterless antiseptic solutions may be used for cleaning hands, if necessary; however, hands should be washed with clean water and soap as soon as it is available. Water-based lotions are acceptable for use after hand washing.

Masks in combination with eye protection devices, such as goggles or glasses with solid side shields, or chin-length face shields, will be worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose or mouth contamination can be reasonably anticipated, such as tracheostomy care. NKY Health staff usually do not perform these procedures.

Appropriate protective clothing such as, but not limited to, gowns, aprons, lab coats, clinic jackets or similar outer garments shall be worn in occupational exposure situations that are likely to generate splashes of blood or other bodily fluids. The type and characteristics will depend upon the task and degree of exposure anticipated.

Although saliva has not been implicated in the transmission of HIV, to minimize risks during emergency mouth to mouth resuscitation, ambu bags are available in patient care areas and must be used by NKY Health staff.