Personal Protective Equipment (PPE)

Personal protective equipment (PPE)
 PPE are items that protect our clothing and uniforms or

vulnerable parts of the body against exposures to
infectious materials, such as:
 blood or body fluids, secretions and excretion.
 Non-intact skin
 Mucosal membranes
 used medical equipment or supplies used on patients or
contaminated environmental surfaces.
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Types of personal protective equipment
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Gloves
Gloves are a disposable barrier, worn for the following reasons:
• First, they protect your hands from potentially infectious
materials, for example, blood, urine, feces, sputum, and
nonintact skin.
• Second, gloves reduce the likelihood of nurses transmitting
their own endogenous microorganisms to individuals
receiving care. Nurses who have open sores or cuts on the
hands must wear gloves for protection.
• Third, gloves reduce the chance that the nurse’s hands will
transmit microorganisms from one client or an object to
another client.
• Fourth, protects hands from toxic and irritant chemicals 3
Types of gloves
There are three types of gloves used in healthcare
facilities:
Þ Examination gloves provide protection to healthcare
workers when performing many of their routine duties.
Þ Surgical gloves should be used when performing
invasive medical or surgical procedures.
Þ Utility or heavy-duty household gloves are indicated
for non-patient care activities, such as:
– Processing instruments, equipment and other items;
– For handling and disposing of contaminated waste;
and
– When cleaning contaminated surfaces. 4
When to wear gloves?
• The Glove Pyramid – aid decision making on
when to wear (and not wear) gloves
• Gloves must be worn according to STANDARD and
CONTACT PRECAUTIONS.
• The pyramid details some clinical examples in which
gloves are not indicated, and others in which clean or
sterile gloves are indicated.
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Some Dos & DON’Ts while glove use
The Dos (good practices) while glove use
• Hand hygiene is performed before putting on gloves.

Unclean hands can contaminate a box of gloves.
• wear the correct size glove
• Change gloves and perform hand hygiene:
– between client contacts.
– periodically during long cases as the protective effect of latex
rubber gloves decreases with time and inapparent tears may
occur.
– if damaged during patient care, e.g., tears or holes.
– if moving from a contaminated body site to an uncontaminated
body site. For example, remove and dispose of gloves after
performing a wound dressing on non-intact skin, and before
performing phlebotomy. 7
The Dos…
• keep fingernails trimmed moderately short
• pull gloves up over cuffs of gown (if worn) to protect the
wrists.
• use water-soluble (nonfat-containing) hand lotions and
moisturizers often to prevent hands from drying, cracking
and chapping due to frequent handwashing and gloving.
• Perform hand hygiene after glove removal.
– It is important to know that hand contamination can occur
during glove removal due to poor technique and also, possibly,
as a result of small, undetected holes in gloves
• Non-powdered gloves are recommended because they
don't react with alcohol-based handrubs.
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The DON’Ts (things that need to be avoided) while glove use.
 Do not wear the same pair of gloves for the care of >1 patient.
 Never wash or reuse disposable gloves.
 Don’t use oil-based hand lotions or creams, because they will
damage latex rubber gloves.
 Don’t use hand lotions and moisturizers that are very fragrant
(perfumed) as they irritate the skin under gloves.
• Don’t store gloves in areas where there are extremes in temperature
(e.g., in the sun, or near a heater, air conditioner, ultraviolet light,
fluorescent light or X-ray machines). These conditions may damage
the gloves (cause breakdown of the material they are made of), thus
reducing their effectiveness as a barrier.
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Prioritizing glove use
•If gloves are limited:
 Reserve them for situations with a high likelihood of
contact with blood or body fluids
 Use other barriers (towels, napkins) when there is no
direct contact with patient secretions, or provide no-
touch care if possible.
 Do not use gloves for activities that are not
considered high-risk (e.g., providing oral
medications)
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•Double gloving
 Double gloving means wearing two sets of gloves.
 This is an appropriate practice for some high-risk
procedures that increase the risk of cuts or punctures to
surgical gloves, like orthopedic procedures.
 Other indications may include disease specific PPE
requirements (e.g., Ebola Virus Disease and other
hemorrhagic fevers) for which easy removal of a soiled
outer layer can be helpful.
 Remember, double gloving is not a substitute for hand
hygiene. 11
...
Gowns; coveralls or plastic aprons
• Gowns or coveralls are physical barriers that protect

clothing and skin when soiling or splashing with blood, body
fluids, secretions, or excretions is likely.
• Coverall are designed to cover the whole-body including legs
and, for hooded models, neck, and head
– Difficult to take off safely, compared to gowns (there is a high
risk of self-contamination)
– More heat stress while wearing coverall creates worker risk in
hot environments
• Aprons are an additional layer that can provide a waterproof
barrier along the front of the body, protecting the gown and
clothing from large volumes of splashes or sprays during
patient care (e.g., during cesarean delivery or vaginal delivery). 12
• Aprons
• Aprons provide a waterproof barrier along the
front of the body, protecting the gown and
clothing of the HCP when large amounts of
splashes or sprays are anticipated during
patient care or cleaning activities. Aprons can
be disposable or reusable, depending on the
material type.
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Respiratory protective equipment(Face
Masks)
 Respiratory protective equipment (RPE) is required
against organisms that are usually transmitted via the
droplet/air‐borne route, or by splatters of body
substances.
 Two types of masks are used in clinical practice as
RPE: surgical masks and respirator masks.
 Note that neither of these masks protects against
gases.
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Surgical masks
 act as a physical barrier providing protection to the
nose, mouth and upper respiratory tract against
sprays, splatter and droplets.
 Loose fit between mask and face
 do not have the filtering efficiencies required for
adequate respiratory protection against aerosols
Respirator masks
 These are special types of masks designed to filter
out air‐borne particles smaller than 5 μm in the
inspired air. 15

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Protective Eyewear and Visors
• Protective eye wear (goggles or visor/face shields) and masks
are indicated in situations where body substances (blood, body
fluids), or chemicals may splatter the face.
– Spectacles and contact lenses are not considered adequate
eye protection.
– If the nurse wear prescription eyeglasses, goggles must still
be worn over the glasses because the protection must extend
around the sides of the glasses.
• While effective as eye protection, goggles do not provide splash
or spray protection to other parts of the face
• With either device, additional PPE (face mask) to protect the
wearer’s nose and mouth should be worn when needed.
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Head covering and footwear
– Head covers—such as caps or hoods—contain long hair
during work and prevent infectious material from
contaminating hair.
– Shoes should be worn at all times in a health care facility.
– Sturdy, closed-toe shoes are recommended for all clinical
areas.
– Rubber boots can provide additional protection in wet or
muddy environments or when using hazardous chemicals.
ÞNote: Open-toed sandals do not provide protection from
blood, body fluids, sharps, and other hazardous materials.
They also do not provide appropriate protection against slips
and falls.
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…
• Donning PPE
• PPE should be put on before the task or procedure for which it is
required.
• The following general principles apply when putting on PPE:
• Check for tears and other damage that could reduce effectiveness
• Check for proper fit (to minimize adjusting during patient care)
• Any item that ties should be tied securely, but not so tightly that
extra manipulation will be needed to take it off
• Perform hand hygiene before donning PPE
• Always ensure the cuff of the glove is overtop the cuff of the gown
if worn together
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• Sequence for Putting on PPE for Standard and
Transmission-based Precautions
1. Put on protective boots or shoe covers (if needed).
2. Perform hand hygiene.
3. Put on a gown.
4. Put on Surgical mask (or respirator mask).
5. Put on goggles or a face shield.
6. Lastly, put on gloves
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Thank you!!
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Personal Protective Equipment (PPE)

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Personal protective equipment (PPE)

 PPE are items that protect our clothing and uniforms or

• Hand hygiene is performed before putting on gloves.

• Gowns or coveralls are physical barriers that protect

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