Personal Protective Equipment (PPE)
Personal Protective Equipment (PPE)
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Personal protective equipment (PPE) describes items such as gloves, aprons, face masks and eye protection which are used during certain procedures. You must ensure that you use the appropriate PPE when performing a clinical procedure to prevent micro-organisms from coming into contact with you or your clothing.
Since there is a high risk of the PPE becoming contaminated, it is essential to remove it as soon as you have completed the procedure and then to thoroughly clean your hands.
Although the care orgnaiasations are required to provide suitable equipment, it is the responsibility of the individual concerned to use it correctly and appropriately.
Remember that wearing PPE is a requirement of the Health and Safety at Work Act 1974 [7] and the Code of Practice (Health and Social Care Act (2008)) Code of Practice on the prevention and control of infection [8].
It is worn to:
Protect staff from infection (micro-organisms/blood/body fluids)
Reduce the spread of micro-organisms to patients
Its use is based on an assessment of the risk of transmission of micro-organisms (to the healthcare worker or the patient) and the risk of contamination of the healthcare worker from the patient’s blood, body fluids, secretions and excretions.
In light of the current coronavirus (Covid-19) pandemic, PPE is vital to protect the healthcare worker and patient. Please follow the guidance.
The wearing of gloves is not a substitute for hand hygiene. Wearing gloves inappropriately (i.e. too frequently/for every task) means that valuable hand hygiene opportunities will be missed and the risk of cross-infection to patients will increase. Gloves and aprons are worn for contact with blood or bodily fluid or infectious patients.
Putting on gloves and/or a disposable plastic apron should be the last thing that the healthcare worker does immediately before he or she has direct contact with the patient.
Disposable plastic aprons and non-sterile gloves are only ‘clean’ at the point at which they are put on. Putting them on too soon before the actual task or episode of patient contact means that they will become contaminated and will no longer be clean. Gloves and aprons are not to protect the patient but to protect the healthcare worker.
Staff must not leave a single room/bay wearing gloves and/or an apron unless there is an emergency or they are removing a bedpan/commode or carrying a vomit bowl/urinal, where there is a potential risk of body fluid spillage.
Aprons
Aprons form part of PPE and must be changed in between each procedure or episode of patient care.
They must be removed as soon as the procedure/episode of care has been completed, and before leaving a side room/bay unless the healthcare worker is taking a commode, bedpan, urinal or dirty/contaminated equipment for disposal.
They must be disposed of as clinical waste after use.
Full, body-length, fluid-repellent gowns should be worn where there is a risk of extensive splashing of blood or body fluids onto the skin or clothing of healthcare workers including contact with infectious patients.
Disposable plastic aprons should be worn when in close contact with a patient, materials or equipment, and where there is a risk that clothing or uniform may become contaminated with micro-organisms, blood, body fluids, secretions or excretions.
Masks
Surgical face masks must be worn for surgery or when in contact with a patient who has a suspected/confirmed transmittable virus. Face masks should also be worn during the coronavirus (COVID-19) pandemic to protect both the healthcare workforce and patient.
They are single-use items of PPE
They need to be secured tightly around the back of the head to ensure that the fit is as close as possible
They are not designed to be worn for long periods
They must be changed when wet
They must be removed following the procedure
They must be disposed of as clinical waste
Filtering face piece (FFP) class 3 disposable respirator masks offer the highest level of respiratory protection and filter particles that include viruses and bacteria. They must be worn when:
Undertaking aerosol-generating procedures on patients with known/identified respiratory pathogens or some suspected ones, for example Middle East Respiratory Syndrome (MERS). Procedures would include intubation or extubation, sputum induction or chest physiotherapy or suctioning
Caring for patients with suspected or confirmed respiratory TB, including multidrug-resistant (MDR) TB, pandemic/avian influenza, Ebola or MERS-CoV
Healthcare staff need to undergo fit testing to ensure that the FFP3 respirator mask is a suitable and close fit for the shape of their face, and that there are no gaps under or around the mask where unfiltered air can pass through.
Fit testing can only be undertaken by someone who has been trained in the procedure
Each time a FFP3 respirator mask is worn, a fit check needs to be undertaken
The same type of mask must be worn that has been fit-tested for, and a fit-check must be performed each time a new FFP3 is worn
FFP3 respirator masks can be worn for up to 8 hours of continuous care
Goggles, Visors and Face Shields
You must ensure that wrap-around goggles, visors or face shields are worn when there is a risk of blood, body fluids, secretions and excretions splashing into the face or eyes.
Gloves
Sterile or non-sterile gloves should be worn either on their own or in conjunction with other PPE.
Invasive procedures
Gloves must be worn during all invasive procedures such as surgery.
Contaminated equipment
Gloves must be used when in contact with sterile body sites. They must also be worn when handling sharp or contaminated equipment.
Chemicals
Gloves must be worn when in contact with non-intact skin. They must be worn when handling chemicals or drugs as COSHH Guidance - see Resources for a link to the guidance.
Bodily fluids
Gloves must be worn when in contact with mucous membranes or where there is a risk of exposure or contact with blood or bodily fluids or micro-organisms.
You must ensure that you know when to use sterile gloves and when to use non-sterile gloves
Sterile gloves
Sterile gloves should be worn for:
Any type of surgical procedure
Lumbar puncture
Inserting central lines
Urinary catheterisation
Vaginal delivery
Non-sterile gloves
Contact with blood, body fluids, micro-organisms, chemicals. For example:
Direct contact with patients in isolation rooms or cohort bays
Cannulation
Venepuncture
Removal of peripheral cannula or urinary catheter
Taking a catheter specimen of urine (CSU)
Taking a wound swab
IV drug administration
Emptying or changing stoma bags, nasogastric tube drainage bags, nappies/incontinence pads, commodes, bedpans, urinals and vomit bowls
Cleaning instruments or equipment
Cleaning up blood/body fluid spills
Handling clinical waste/soiled linen
Putting On and Removing PPE
Important Information
Donning (putting on) and doffing (removing) PPE in the right order or sequence is important as it minimises the risk of cross infection and also minimises the risk of, or prevents, inadvertent contamination of the healthcare worker.
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