dress code & use of personal protective equipment in … · 2018-05-26 · why? •patients are...
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DRESS CODE & USE OF PERSONAL PROTECTIVE
EQUIPMENT IN THE M.D.R.D., O.R., & ENDOSCOPY
Will it be scents or common sense?
•Most, if not all hospitals have scent‐free environment policies in place.
Why?•Patients are sick, nauseated and sensitive.•Co‐workers, visitors, patients may have
allergies.•Perfumes/lotions may interfere with
barrier properties of gloves.
COSMETICSAre you being ‘FLAKY’?????
• Glitter lotion/glitter cosmetics –
forbidden!!!
• False eyelashes –
forbidden!!!
• Heavy mascara –
forbidden!!!
FINGER NAILS – A ‘GROWING’ CONCERN
• False nails/extenders –
forbidden!!!*Known to promote growth of Staph. Aureus, gram
negative bacilli and yeast*May tear/cut gloves
• Finger nails should be clean, short (less than ¼”
long, natural tip), and healthy
*damaged, long nails provide a place for organisms to hide and grow; damaged cuticles harbour micro‐
organisms and there is an increased risk to technician (open wound on hand)
Fungal nail infection
FINGER NAILS – A ‘GROWING’ CONCERN
• Nail polish – must be undamaged and preferably clear
*cracks harbour micro‐organisms; dark colour hides dirt under nails
LOVE THE ‘BLING’
–
A GIFT THAT KEEPS ON GIVING
• Earrings **small stud type ‐
stones can fall out, backers
can fall off (into instrument tray), build‐up of dirt between cleanings
**dangling type – movement promotes shedding of skin cells, micro‐organisms; risk
of parts falling off• Neck chains/Lanyards **movement causes shedding of skin cells
LOVE THE ‘BLING’
–
A GIFT THAT KEEPS ON GIVING
(DEBRIS, MICRO‐ORGANISMS, ETC…)
• Rings**only plain band allowed –
anything else risks
cuts to gloves, increased numbers of micro‐ organisms in grooves/stone settings; risk of stones falling out
**studies show skin under plain bands more heavily colonized than skin without any rings
(ORNAC Standard #5.3.11 June 2009)
BASICALLY, REMOVE ALL JEWELLERY!!!!!!
UNIFORMS• Wear hospital laundered scrubs
Allergies?? – Some hospitals do an extra rinse of laundry for patients/staff who experience rashes from laundry soap.
If not: Some discussion of isolating clean scrubs in home washer for rinse in hottest water, dried on hottest cycle, then packaged and sterilized as linen
bundle at facility before wearing. Not recommended as there is no standard to back up
this practice. High risk of introducing pet hair/human hair to MDRD environment.
UNIFORMS• Don freshly laundered scrubs daily. Change
immediately if becomes soiled/wet.
• Scrubs not to be worn home. Soiled scrubs never to be taken home for laundering.
• Long sleeve undershirts not completely covered by scrub top shall not be worn.
• Scrubs should be changed if worn outside (ie: moving between buildings)‐use of cover gowns/lab
coats to be determined by facility (ORNAC Standard June 2009)
• Warm up jackets and cloth hats –
changed daily and hospital laundered.
SHOES• MADE OF MATERIAL THAT IS EASILY CLEANED
• HAVE ENCLOSED TOES AND HEELS• TOE AREA MADE OF SUBSTANTIAL MATERIAL THAT
CAN WITHSTAND HAVING A HEAVY INSTRUMENT DROPPED ON IT
• SHOE COVERS WORN IF RISK OF SPLASHING OR SPILL OF CONTAMINATED FLUIDS
• SOLES MADE OF NON‐SKID MATERIAL
• COMFORTABLE, GOOD SUPPORT
QUESTIONS????
PERSONAL PROTECTIVE EQUIPMENT
HAIR COVERING• SELECT A STYLE THAT WILL COVER ALL HEAD
AND FACIAL HAIR (includes hair at nape of neck, sideburns, moustaches and beards, but
not eyebrows/eyelashes)**Hair has been proven to attract, harbour and shed micro‐
organisms in relation to its’
length, curliness and oiliness.
Moustaches and beards are particularly susceptible to
micro‐organisms/food particles due to obvious proximity to
mouth/nose, so a procedure mask is required too (or
shave!!!!)
• TO BE CHANGED DAILY, IF SOILED, WORN OUTSIDE, OR
WHEN LEAVING DECONTAM ROOM
HAIR COVERINGSo, what should I wear to cover my hair?
No, this is not necessary, but what is available?
HAIR COVERINGBOUFFANT CAPS ‐
disposable
HAIR COVERING• BOUFFANT CAPS –
reusable
HAIR COVERINGSURGEON CAPS
Disposable
Reusable
HAIR COVERINGSURGEON HOODS
FACIAL HAIR COVERING
FACIAL PROTECTION• IN PREP AND PACK ROOM:
>SAFETY GLASSES – WHEN WORKING WITH ANY BIOLOGICAL CHALLENGE DEVICE
• IN DECONTAMINATION ROOM:
>FULL FACE SHIELD – EITHER REUSABLE OR DISPOSABLE
>SAFETY GLASSES AND HIGH FILTRATION/FLUID
IMPERVIOUS MASK (not as desirable because neck is not protected and is uncomfortable)
FACIAL PROTECTIONSafety Glasses
FACIAL PROTECTION
PROTECTIVE GOWNS• MUST BE WORN WHEN PERFORMING ANY
DECONTAMINATION DUTIES
• MUST BE LONG SLEEVE, FLUID IMPERVIOUS, FULL LENGTH
• COMES IN REUSABLE AND DISPOSABLE
• RECOMMENDED TO WEAR LIGHT PLASTIC APRON OVER REUSABLE FLUID IMPERVIOUS
GOWN FOR PROTECTION OF ABDOMEN OR GOWN TO BE CHANGED IMMEDIATELY.
PROTECTIVE GOWNS
PROTECT YOUR HANDS!!!!• PREP AND PACK SIDE>NITRILE POWDER FREE GLOVES
1.WHEN HANDLING ANY BIOLOGICAL CHALLENGE DEVICE
2.WHEN HANDLING LOW TO MID‐LEVEL DISINFECTED ITEMS
PROTECT YOUR HANDS!!!!• PREP AND PACK ROOM:
>WASHABLE, REUSABLE, TEMPERATURE RESISTANT, SILICONE MITTS:
1.FOR HANDLING LOADING RACKS FROM WASHER/DISINFECTOR
2.FOR HANDLING HOT ITEMS
3.FOR PULLING CARTS OUT OF STERILIZER
Silicone high temp gloves for unloading washer or sterilizer
PROTECT YOUR HANDS!!!!• IN DECONTAMINATION ROOM:
>12”CHEMICAL RESISTANT GLOVES (IE: NITRILE) MUST BE WORN
>CHEMICAL RESISTANT GLOVES MAY BE DISPOSABLE OR REUSABLE
>BETTER TACTILE SENSE WHEN USING DISPOSABLE
>REUSABLE GLOVES MUST BE DECONTAMINATED AND DRIED EACH DAY
AND BETWEEN USERS
And don’t forget your feet!!!!• SHOE COVERS>NEEDED WHEN WORKING IN
DECONTAMINATION AREA DUE TO RISK OF SPLASHING
>MUST BE REMOVED WHEN LEAVING DECONTAMINATION AREA (PROTECTS REST
OF FACILITY ENVIRONMENT)
>MUST BE NON‐SKID CONSTRUCTION ON BOTTOM
AND PROPER ATTIRE FOR GUESTS OF THE MDRD...............
BUNNY SUIT
OKAY, NOW TAKE IT ALL OFF!!!!!• Sequence for removing PPE
• all items must be removed and discarded carefully
• perform hand hygiene after removal of gloves and again after gown removal (before your hands go
near your face for removal of masks and eye protection) and after completion of PPE removal,
and any time you suspect your
hands are contaminated during PPE removal.
• 1. Glove removal
• outside of glove is ‘dirty’; use glove‐to‐glove/• skin‐to‐skin handling method
• grasp outside edge near wrist
• peel away from hand, turning glove inside out
• hold in opposite gloved hand
• slide ungloved
finger under wrist of remaining glove
• peel off from inside, creating a bag for both gloves
• discard
• Perform hand hygiene using soap and water.
2. Gown removal
• gown front and sleeves are ‘dirty’; handle by
inside/back of gown
•
unfasten ties
•
peel gown away from neck and shoulder
• turn contaminated outside surface toward the inside
• fold or roll into a bundle
• discard
3. Perform hand hygiene using soap and water
4. Eyewear removal
• outside of eyewear is ‘dirty’; handle by earpieces/straps
• grasp earpieces/straps with un‐gloved hands
•
pull away from face
• place in designated receptacle for reprocessing or discard if disposable
5. Mask removal
•
front of mask is ‘dirty’; handle by ear‐loops
• remove from face, in a downward direction,
using ear‐loops
• discard
6. Perform hand hygiene immediately after
removing PPE, using soap and water.
Resources:1.
ORNAC Standards (Operating Room Nurses
Association of Canada)
2.
CSA Standards (Canadian Standards Association)
3.
AAMI Standards (Association for the Advancement of Medical Instrumentation)
4.
CHICA Canada (Community and Hospital Infection Control Association –
Canada)
QUESTIONS??