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

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

Isolation ProceduresIsolation 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 PrecautionsWhen 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 PrecautionsMost 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 PrecautionsTalking or sneezing patients can

spread disease 3 feet.Ex/ Influenza, Pertussis

(whooping cough), mumpsWear surgical mask

Airborne PrecautionsPatients 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 gloveWash handsDon gloves

Removing Gloves

ONLY GLOVE CAN TOUCH GLOVEGrasp with one hand just below cuffPull glove down over hand so that it is

inside outHold removed glove with gloved handReach inside remaining glove with 1st 2

fingers of ungloved hand (touch inside only)

Pull glove down over hand and other glove

Discard and wash hands

Donning and Removing a GownFollow along with instructional

video, then consult your skills check list.

https://www.youtube.com/watch?v=_IYrqiQjvyQ

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