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Use%20of%20PPEs

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Dr. Michael O. Oji Chair, Infection Control, Lagoon Hospitals Infection Control Ambassador for Society for Healthcare Epidemiology of America (SHEA) – PowerPoint PPT presentation

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Title: Use%20of%20PPEs


1
Use of PPEs
  • Dr. Michael O. Oji
  • Chair, Infection Control, Lagoon Hospitals
  • Infection Control Ambassador for Society for
    Healthcare Epidemiology of America (SHEA)

2
Outline
  • Learning Objectives
  • Introduction
  • Definitions
  • Infection Control Precautions
  • Indications and Types
  • Appropriate Use
  • Challenges
  • Conclusion
  • Recommendations
  • References

3
Learning Objectives
  • Understand what are PPEs.
  • Understand basic principles of Infection Control
    Precautions.
  • Understand Appropriate Use.
  • Understand the Risks and how to manage them.

4
Introduction
We must never accept that injury, illness or
death is the cost of doing business." President
Obama April 2014
"No one should have to sacrifice their life for
their livelihood, because a nation built on the
dignity of work must provide safe working
conditions for its people." Secretary of Labor
Thomas E. Perez.
5
Definitions-PPEs
  • specialized clothing or equipment worn by an
    employee for protection against hazardous/
    infectious materials.
  • Specialized
  • Personal
  • Protective
  • Equipment

6
Infection Control Precautions
  • Infection control precautions are a set of
    standard recommendations designed to reduce the
    risk of transmission of infectious agents from
    body fluids or environmental surfaces that
    contain infectious agents.
  • Standard
  • Contact
  • Droplet
  • Airborne
  • Full Barrier

7
Standard Precautions
  • Previously called Universal Precautions
  • Assumes blood and body fluid of ANY patient could
    be infectious
  • Recommends PPE and other infection control
    practices to prevent transmission in any
    healthcare setting
  • Decisions about PPE use determined by type of
    clinical interaction with patient

8
PPE for Standard Precautions (1)
  • Gloves Use when touching blood, body fluids,
    secretions, excretions, contaminated items for
    touching mucus membranes and non intact skin.
  • Gowns Use during procedures and patient care
    activities when contact of clothing/ exposed skin
    with blood/body fluids, secretions, or excretions
    is anticipated

9
PPE for Standard Precautions (2)
  • Mask and goggles or a face shield Use during
    patient care activities likely to generate
    splashes or sprays of blood, body fluids,
    secretions, or excretions

10
What Type of PPE Would You Wear?
  • Giving a bed bath?
  • Suctioning oral secretions?
  • Transporting a patient in a wheel chair?
  • Responding to an emergency where blood is
    spurting?
  • Drawing blood from a vein?
  • Cleaning an incontinent patient with diarrhea?
  • Irrigating a wound?
  • Taking vital signs

11
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?
  • Depends on the pt-gloves,face-mask?
  • 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

12
Use of PPE for Expanded Precautions
  • Contact Precautions Gown and gloves for contact
    with patient or environment of care (e.g.,
    medical equipment, environmental surfaces)
  • In some instances these are required for entering
    patients environment
  • Droplet Precautions Surgical masks within 3
    feet of patient
  • Airborne Infection Isolation Particulate r
  • eNegative pressure isolation room also required
  • spirator

13
Contact Precautions
  • Contact Precautions Gown and gloves for contact
    with patient or environment of care (e.g.,
    medical equipment, environmental surfaces)
  • In some instances these are required for entering
    patients environment
  • MRSA
  • VRE
  • EVD

14
Droplet Precautions
  • Droplet Precautions Surgical masks within 3
    feet of patient
  • Common cold
  • Influenza
  • EVD

15
Airborne Precaution
  • Airborne Infection Isolation Particulate
    respirator
  • gt3feet
  • TB
  • ?EVD

16
Full Barrier Precaution
  • Gloves and Gowns
  • Head and Shoe covers
  • Eye and face protection

Head Cover
Face Shield
Goggle
Respirator
Strapping
Apron
Hazmat Suit
Glove
Boot
17
Hand Hygiene
  • Required for Standard and Expanded Precautions
  • Perform
  • Immediately after removing PPE
  • Between patient contacts
  • Wash hands thoroughly with soap and water or use
    alcohol-based hand rub

18
Components
  • Gloves
  • Gowns
  • Shoes and Head Covers
  • Masks and Respirators
  • Face and Eye Protection

19
Gloves
  • Directly handling potentially infectious or
    contaminated surfaces.
  • Change when visibly soiled, torn or punctured.
  • Part of Standard or Contact Precaution
  • Hand Hygiene on Removing gloves.

20
How to Don Gloves
  • Don gloves last
  • Select correct type and size
  • Insert hands into gloves
  • Extend gloves over isolation gown cuffs

21
Gowns
  • Protect from potentially infectious material
  • Cover torso, close body fitting, arms to wrists.
  • Appropriate Disposable, Re-Useable,
    Fluid-Resistant, Non-Fluid resistant, Sterile
    ,Clean
  • Standard and Contact P.

22
Shoes and Head Covers
  • Barrier for Environmental Protection.
  • Use for Haemorrahgic diseases
  • When sprays or airborne exposure
  • Must be worn as part of FBP

23
Masks (M)and Respirators(R)
  • M. protects nose and mouth from splattered body
    fluids.
  • R. filters air before inhalation
  • Disposable R N95
  • Powered Air Purifying R. (PAPR)
  • Self Contained Breathing Apparatus R. (SCBA)

24
Sequence for Donning PPE
  • Gown first
  • Mask or respirator
  • Goggles or face shield
  • Gloves
  • Combination of PPE will affect sequence be
    practical

25
How to Don a Gown
  • Select appropriate type and size
  • Opening is in the back
  • Secure at neck and waist
  • If gown is too small, use two gowns
  • Gown 1 ties in front
  • Gown 2 ties in back

26
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

27
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

28
Face and Eye Protection.
  • Protect mucous membranes of eyes, nose, mouth
    and facial skin.
  • Part of Standard Resp. Precaution.

29
How to Don Eye and Face Protection
  • Position goggles over eyes and secure to the head
    using the ear pieces or headband
  • Position face shield over face and secure on brow
    with headband
  • Adjust to fit comfortably

30
Using your PPEs
  • 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

Head Cover
Shield
Goggle
Respirator
strapping
Apron
Hazmat Suit
Gloves
Boots
31
Principles Guiding the Use of PPEs
  • Who or What?
  • What is the Risk?
  • What Precaution type?
  • What Components?
  • Manufacturers Specifications?
  • Donning and Doffing?
  • Unidirectional?
  • Appropriate Disposal
  • Documentation

32
PPE matrix
33
KYP?
  • MRSA
  • TB
  • HiNI
  • EVD/ Haemorrahgic Fevers

34
Donning
35
Doffing-Removing PPEs
36
Doffing
  • An Assistant?
  • Pre-planned Sequential .
  • Remove apron
  • Shoe covers and Outer gloves and shoe cover.
  • Step into Hazard Bag

37
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

38
Sequence for Removing PPE
  • Gloves
  • Face shield or goggles
  • Gown
  • Mask or respirator

39
Where to Remove PPE?
  • At doorway, before leaving patient room or in
    anteroom
  • Remove respirator outside room, after door has
    been closed
  • Ensure that hand hygiene facilities are
    available at the point needed, e.g., sink or
    alcohol-based hand rub

40
Removing PPEs ? Ebola
41
How to Remove Gloves (1)
  • Grasp outside edge near wrist
  • Peel away from hand, turning glove inside-out
  • Hold in opposite gloved hand

42
How to Remove Gloves (2)
  • Slide ungloved finger under the wrist of the
    remaining glove
  • Peel off from inside, creating a bag for both
    gloves
  • Discard

43
Remove Goggles or Face Shield
  • Grasp ear or head pieces with ungloved hands
  • Lift away from face
  • Place in designated receptacle for reprocessing
    or disposal

44
Removing Isolation Gown
  • Unfasten ties
  • Peel gown away from neck and shoulder
  • Turn contaminated outside toward the inside
  • Fold or roll into a bundle
  • Discard

45
Removing a Mask
  • Untie the bottom, then top, tie
  • Remove from face
  • Discard

46
Removing a Particulate Respirator
  • Lift the bottom elastic over your head first
  • Then lift off the top elastic
  • Discard

47
Challenges
  • Cost
  • Availability
  • Training
  • Appropriate Use
  • Appropriate Disposal

48
Challenges
  • Cost
  • Availability
  • Training
  • Appropriate Use
  • Appropriate Disposal

49
Conclusion
  • Correct PPE Use
  • Protect yourself and others

50
References
  • 2007 Guideline for Isolation Precautions
    Preventing Transmission of Infectious Agents in
    Healthcare Settings . CDC.
  • WHO. Standard Precautions in HealthCare. Oct
    2007. Infection Control
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