Gloves and Other Personal Protective Equipment

Barriers include gloves, gowns or plastic aprons, masks, and eye protection. Various types of barriers are used, along with handwashing, to prevent the spread of infec-tion. Barriers protect your hands, skin, clothing, eyes, and mucous membranes from microorganisms. They also protect residents from microorganisms that may be on your hands, skin, or clothing.

Standard precautions require that gloves be worn in the following situations:

■ When touching blood, body fluids, secretions, excre-tions, or contaminated items.

■ When touching mucous membranes or broken(non-intact) skin.

Most often, you will need single-use disposable gloves. Gloves are made from different materials. Most are made of latex, but non-latex gloves are available for people who are allergic to latex. These gloves are packaged as clean, not sterile. Some types of gloves fit better than others. Your facility will have various sizes of gloves on hand. Good-fitting gloves are needed for fine motor skills. Most of the time, you do not need sterile gloves or tight-fitting gloves.

Gloves must be changed between tasks, before giving care to another resident, and before touching noncon-taminated items and environmental surfaces. Change your gloves and wash your hands before caring for each resident and anytime the gloves become visibly contam-inated. You must wash your hands after removing gloves because they may become contaminated from small defects, from tears in the gloves that occurred during use, or when removing the gloves. You must also change your gloves when moving from a contaminated body site to a clean one. The correct steps for putting on and removing gloves are shown in Procedure 2-1.

When you clean equipment or surfaces like a bedside table, you should wear heavy utility gloves (Figure 2-2) rather than single-use disposable gloves. The chemicals in cleaning solutions can irritate your hands, and heavy utility gloves offer better protection. You can reuse utility gloves unless they are cracked, torn, or worn out, just as you reuse similar gloves at home.

Figure 2-2 When cleaning, heavy utility gloves (left) should be worn rather than single-use gloves (right).

GownsGowns are made of cloth, paper, or plastic. A clean, nonsterile gown should be worn to protect your skin and prevent soiling of your clothing when you perform tasks that may splash or spray you with blood, body fluids, secretions, or excretions. Wear a gown when a resident has diarrhea, is vomiting, or has large amounts of drainage from a wound. A soiled gown should be removed as soon as possible after completing your task. If you are using gloves and a gown, put the gown on first and then the gloves. Remove the gown after completing your task with the resident. The correct steps are shown in Procedure 2-2.

Plastic aprons are barriers that cover the front of your clothing. They are particularly useful in situations in which your clothing may get wet, such as when you are helping a resident to bathe. Plastic aprons are also useful when changing soiled linen that cannot easily be folded in on itself to contain the soiled area. Disposable plastic aprons usually have a neck strap and ties at the waist. They do not protect your arms. When you need to wear gloves and a plastic apron, put the apron on first, then the gloves. Remove the gloves first, then the apron. Be sure to wash your hands after removing the apron.

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Preventing Infection While Providing Personal Care

2-1 Putting on and Removing Gloves

PUTTING ON GLOVES:

Wash your hands.

Slip gloves on, covering your entire hand and wrist.

If you are putting on gloves along with a gown and mask, put the gown on first, then the mask, and then the gloves. Pull the gloves up over the gown’s cuffs.

REMOVING GLOVES:

Gloves are removed after you complete a task. Use the steps shown below if you are right-handed. If you are left-handed, use the opposite hand.

Using your right hand, grasp the glove on the left hand at the inside of the wrist, turning the glove inside out as you pull it down over your left hand.

Hold the used left glove in a ball in your gloved right hand.

Grasp the inside of the right glove at the top of the wrist with your left hand.

If you are wearing fitted, sterile gloves, you will not be able to grasp the inside of the top of the right glove, so you must cuff (fold over) the top of the right glove before you begin to remove the glove.

Pull the right glove down over your right hand and over the used glove held in that hand. The right glove is now inside out, with the left glove enclosed in it.

Place the gloves in the trash receptacle. Follow your facility’s infection control policies to dispose of soiled waste.

Wash your hands.

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PROCEDUREPROCEDURE

2-2 Putting on and Removing a Gown

PUTTING ON A GOWN:

Insert your arms in the sleeves, with the opening in the back.

Tie the gown at your neck and waist.

Put on your gloves and pull the gloves up over the gown’s cuffs.

REMOVING A GOWN:

Remove your gloves first and dispose of them properly.

Untie the gown at your neck and waist.

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PROCEDUREPROCEDURE

PROCEDURE

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ITEM3 Grasp the cuff of one of thesleeves and pull the sleeve down over that hand.

Pull the other sleeve off with your covered hand.

Carefully roll up the gown, keeping the soiled surface inside.

When removing a cloth gown that will be laundered, put it in the appropriate linen hamper. Place a disposable paper gown in the appropriate trash receptacle, following your facility’s policy.

Wash your hands.

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Face ProtectionSurgical/procedure masks, visors, goggles, and face shields are used to protect the mucous membranes of your eyes, nose, and mouth during tasks that are likely to involve splashes or sprays of blood, body fluids, secretions, or excretions. For example, face protection is used when emptying a Foley catheter drainage bag or assisting a nurse with suctioning a resident.

Masks. Masks are an effective barrier to splashes or splat-ters, and they also protect against inhaling droplets in the air. The mask must fit tightly so that you do not inhale air easily around the sides of the mask. If you will be spending a long time with a resident with an infectious disease, change your mask every 20 minutes, sooner if it becomes moist. Very few situations in long term care facilities require wearing a mask to protect residents from you, but you do need to wear a mask to protect residents from droplets if you have a cold with a cough.

Although there are different kinds of masks, all have a metal bar on the bridge of the nose and ties, straps, or elastic to secure the mask. If you need to wear a mask, gloves, and a gown or apron, put on the gown or apron first. Then put on the mask, and put on the gloves last. Remove the gloves first, then the gown or apron, and then the mask. Wash your hands after you have removed all these barriers.

Eye protection. Goggles or glasses with side shields protect the eyes from splashes and splatters (Figure 2-3). You will rarely be in a situation that requires eye protection, but you must know how to use it. If you wear eyeglasses that you want to use for splash protection, they must have side shields, which are add-on devices. The infection control practitioner in your facility can help you locate the correct side shields for your glasses.

If you do not wear glasses and need eye protection, you can use goggles or a face shield. Goggles can be washed, dried, and reused, as can most face shields. Some manufacturers make a single-use combination mask and eye protection shield. These shields can be worn over corrective eyeglasses and protect against splashes from the front and sides.

If you are using eye protection and a mask along with a gown or plastic apron and gloves, put on the eye pro-tection when you put on the mask. Remove it when you remove the mask. As always, wash your hands after you remove all barriers.

Figure 2-3 Goggles protect the eyes from splashes or splatters

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DISCLAIMER: AHCA/NCAL has created this course to assist providers to recruit and train temporary staff during the national emergency caused by the coronavirus pandemic. Federal and/or state requirements may need to be waived to permit individuals under this training program in your location. Employers should check with their state survey agencies and their state occupational licensing agencies where applicable to ensure individuals trained under this program are permitted to assist with care in your location.