Medical Skills: PPE -Removing gloves -Donning and removing a gown -Types of isolation

Isolation Procedures Isolation precautions create a barrier between germs and people & decrease transmission Check for isolation signs before entering a room There are standard and transmission based precautions

Standard Precautions When close to or handling blood, body fluids, tissues, or mucous membranes use one or more forms of PPE PPE (personal protective equipment) Gloves (hand contact w/ body fluids) Mask, goggles (splash risk or spray risk) Apron, gown, shoe covers (anticipate clothing contact with body fluids)

Transmission Based Precautions Most transmission based precautions are done in addition to standard precautions Contact precautions- for germs spread by touching Ex/severe intestinal diseases; Norovirus, and C. difficile Gown and glove

Droplet Precautions Talking or sneezing patients can spread disease 3 feet. Ex/ Influenza, Pertussis (whooping cough), mumps Wear surgical mask

Airborne Precautions Patients in negative pressure rooms (where air is gently sucked out, not allowed to enter hallway) Ex/measles, TB (tuberculosis), chickenpox Wear well-fitted respirator mask

Donning Non-sterilized glove Wash hands Don gloves

Removing Gloves ONLY GLOVE CAN TOUCH GLOVE Grasp with one hand just below cuff Pull glove down over hand so that it is inside out Hold removed glove with gloved hand Reach inside remaining glove with 1 st 2 fingers of ungloved hand (touch inside only) Pull glove down over hand and other glove Discard and wash hands

Donning and Removing a Gown Follow along with instructional video, then consult your skills check list. QjvyQ

How to Don a Gown Select appropriate type and size Opening is in the back PPE Use in Healthcare Settings

How to Don a Mask Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with ties or elastic Adjust to fit PPE Use in Healthcare Settings

How to Don a Particulate Respirator Select a fit tested respirator Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with elastic Adjust to fit Perform a fit check – –Inhale – respirator should collapse –Exhale – check for leakage around face PPE Use in Healthcare Settings

How to Don Gloves PPE Use in Healthcare Settings Don gloves last Select correct type and size Insert hands into gloves Extend gloves over isolation gown cuffs

Sequence* for Donning PPE Gown first Mask or respirator Goggles or face shield Gloves *Combination of PPE will affect sequence – be practical PPE Use in Healthcare Settings

How to Safely Use PPE Keep gloved hands away from face Avoid touching or adjusting other PPE Remove gloves if they become torn; perform hand hygiene before donning new gloves Limit surfaces and items touched PPE Use in Healthcare Settings

“Contaminated” and “Clean” Areas of PPE Contaminated – outside front 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 Clean – inside, outside back, ties on head and back Areas of PPE that are not likely to have been in contact with the infectious organism PPE Use in Healthcare Settings

Sequence for Removing PPE Gloves Face shield or goggles Gown Mask or respirator PPE Use in Healthcare Settings

Do’s and Don’ts of Glove Use 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 necessary during patient care PPE Use in Healthcare Settings

What Type of PPE Would You Wear? 1.Giving a bed bath? 2.Suctioning oral secretions? 3.Transporting a patient in a wheel chair? 4.Responding to an emergency where blood is spurting? 1.Drawing blood from a vein? 2.Cleaning an incontinent patient with diarrhea? 3.Irrigating a wound? 4.Taking vital signs? PPE Use in Healthcare Settings

What Type of PPE Would You Wear? Giving a bed bath? Generally none Suctioning oral secretions? Gloves and mask/goggles or a face shield – sometimes gown Transporting a patient in a wheel chair? Generally none required Responding to an emergency where blood is spurting? Gloves, fluid-resistant gown, mask/goggles or a face shield Drawing blood from a vein? Gloves Cleaning an incontinent patient with diarrhea? Gloves w/wo gown Irrigating a wound? Gloves, gown, mask/goggles or a face shield Taking vital signs? –Generally none PPE Use in Healthcare Settings