Types of personal protective equipment: Clinical skills notes

Notes

Infection Control

Types of personal protective equipment

INTRODUCTION
When providing client care, personal protective equipment, or PPE for short, should be used to avoid transmission of infection to and from the client. This includes wearing non-sterile gloves, a gown, a mask, goggles, or a face shield as needed. The PPE needed depends on the type of the procedure, the client, and the risk for exposure to body fluids. 
Figure 1: Types of personal protective equipment. 
NON-STERILE GLOVES
Non-sterile gloves should be used every time there is a risk for exposure to: 
  • blood 
  • all types of body fluids, secretions, and excretions 
  • open skin lesions or rashes 
  • mucosal surfaces, such as when providing perineal care 
  • possibly contaminated items, such as soiled clothing and linens or contaminated surfaces 

General considerations

  • The gloves must be intact without any holes, so make sure you don’t tear them when putting them on. Long and rough fingernails or rings can also tear the gloves. 
  • Ensure that the gloves fit properly, meaning that they’re not too loose or too tight, and cover your wrists.
  • If you or the client is sensitive to latex, use gloves that are from a different material, such as vinyl.
  • Use a different pair of gloves for every client and for every procedure.
  • When caring for a client, change gloves when moving from a contaminated site of their body, such as the perineum, to a site that’s cleaner.
  • Remove contaminated gloves when you need to touch a commonly used item or surface, such as a light switch, door handle, or faucet.
  • Always consider the outside of the gloves as contaminated and the inside as clean.
  • When removing the gloves, turn them inside out and dispose of them safely.
  • Wash your hands before putting on gloves and after removing them.
GOWNS
Waterproof gowns usually open at the back and will cover you from the neck to the knees. The sleeves should cover the entire arm and have cuffs that are tight.

Gowns should be used:
  • if there’s a possibility that your clothes will get contaminated with blood, all types of body fluids, secretions, and excretions 
  • for procedures where splashes of body fluids are likely
Figure 2: Gowns. A. Waterproof gown fitting. BRisk of contamination if not wearing a gown. 

General considerations

  • Each gown should be used only once, so remember to change the gown between clients 
  • When using a gown, consider the arms and front of the gown contaminated
  • If you’re wearing a non-waterproof gown and it becomes wet, consider it contaminated; dispose of it safely and change to a dry one
MASKS

PPE also includes wearing a mask that covers the nose and the mouth. A mask can protect you from inhaling microbes through the nose or mouth as well as protect the clients from the microbes that you exhale. 

Airborne pathogens can survive and travel through the air over long distances and for an extended period of time, usually several hours to days. And every time a person infected with a microbe that is transmitted by droplets talks, coughs, or sneezes, loads of tiny droplets containing the pathogen are sprayed out. These droplets can land on another person’s mouth, nose, or eyes, allowing the pathogen to enter a new person. So, wear a mask:

  • when there’s a possibility of transmission of airborne pathogens to and from the client 
  • when you will be closer than one meter (three feet) to a person infected with a microbe that is transmitted via droplets
  • when performing a sterile procedure

Surgical masks

For most cases, a simple surgical mask can be used. When wearing a surgical mask, there are some common tips.
  • Always wash your hands before applying the mask.
  • Each mask should be used only for one client.
  • Dispose of the mask if it becomes wet, moist, or soiled. Even breathing can make the mask moist, so change it when that occurs.
  • Always consider the front side of the mask contaminated. If you accidentally touch it, wash your hands immediately.
  • When removing the mask, use the elastic bands or the ties and wash your hands after.

Special high filtration masks / N95 respirators

Special high filtration masks, or N95 respirators, can filter infectious airborne particles at a 95% or even better efficiency. N95 respirators are used when:
  • there’s a high risk of exposure to a very contagious agent, such as when caring for a client with tuberculosis 
  • in the event of a disaster, where there’s release of toxic agents in the environment 

N95 respirators come in various sizes, so make sure yours has been properly fitted specifically to your face in advance.  
Figure 3: Types of masks. A. Surgical mask. B. Special high filtration masks, or N95 respirator. 
GOGGLES & FACE SHIELDS
Goggles protect your eyes. Face shields can be attached to a mask or to an elastic band that wraps around the head. Goggles and face shields can both be worn over your prescription eyeglasses. They are used for procedures where splashes of body fluids are likely, such as when:
  • providing care 
  • cleaning equipment 
  • disposing of fluids  

General considerations

  • Always consider the front of goggles or a face shield contaminated. If you accidentally touch them, wash your hands immediately. 
  • When removing them, use the ties or the head band.
  • After use, dispose of them safely or clean them properly before using them again.
Figure 4: A. Goggles. B. Face shield. C. Healthcare provider wearing a face shield, surgical mask, gloves and a gown.