use of ppes
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Use of PPEs. Dr. Michael O. Oji Chair, Infection Control, Lagoon Hospitals Infection Control Ambassador for Society for Healthcare Epidemiology of America (SHEA). Outline. Appropriate Use Challenges Conclusion Recommendations References. Learning Objectives Introduction Definitions - PowerPoint PPT PresentationTRANSCRIPT
Dr. Michael O. OjiChair, Infection Control, Lagoon
HospitalsInfection Control Ambassador for
Society for Healthcare Epidemiology of America (SHEA)
Learning Objectives
Introduction Definitions Infection Control
Precautions Indications and
Types
Appropriate Use Challenges Conclusion Recommendations References
Understand what are PPEs.
Understand basic principles of Infection Control Precautions.
Understand Appropriate Use.
Understand the Risks and how to manage them.
“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.
• specialized clothing or equipment worn by an employee for protection against hazardous/ infectious materials.
• Specialized
• Personal
• Protective
• Equipment
• 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
• 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
• 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
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
• 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
• 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
• 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 patient’s environment
• Droplet Precautions – Surgical masks within 3 feet of patient
• Airborne Infection Isolation – Particulate r• eNegative pressure isolation room also
required
• spirator
• 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 patient’s environment
MRSA VRE EVD
Droplet Precautions – Surgical masks within 3 feet of patient
Common cold Influenza EVD
Airborne Infection Isolation – Particulate respirator
>3feet TB ?EVD
Gloves and Gowns Head and Shoe
covers Eye and face
protection Apron
Face Shield
Respirator
Strapping
Hazmat Suit
Boot
Glove
Goggle
Head Cover
• 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
Gloves Gowns Shoes and Head
Covers Masks and
Respirators Face and Eye
Protection
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.
• Don gloves last• Select correct type and size• Insert hands into gloves
• Extend gloves over isolation gown cuffs
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.
Barrier for Environmental Protection.
Use for Haemorrahgic diseases
When sprays or airborne exposure
Must be worn as part of FBP
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)
• Gown first• Mask or respirator• Goggles or face shield• GlovesCombination of PPE will affect
sequence – be practical
• 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
• Place over nose, mouth and chin
• Fit flexible nose piece over nose bridge
• Secure on head with ties or elastic
• Adjust to fit
• 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
Protect mucous membranes of eyes, nose, mouth and facial skin.
Part of Standard & Resp. Precaution.
• 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
• 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
GoggleShield
Respirator
strapping Apron
Hazmat Suit
Gloves
Boots
Who or What?
What is the Risk?
What Precaution type?
What Components?
Manufacturers Specifications?
Donning and Doffing?
Unidirectional?
Appropriate Disposal
Documentation
MRSA
TB
HiNI
EVD/ Haemorrahgic Fevers
An Assistant?
Pre-planned & Sequential .
Remove apron Shoe covers and
Outer gloves and shoe cover.
Step into Hazard Bag
• 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
• Gloves• Face shield or goggles• Gown• Mask or respirator
• 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
• Grasp outside edge near wrist• Peel away from hand, turning glove inside-
out• Hold in opposite gloved hand
• Slide ungloved finger under the wrist of the remaining glove
• Peel off from inside, creating a bag for both gloves
• Discard
• Grasp ear or head pieces with ungloved hands
• Lift away from face• Place in designated receptacle for
reprocessing or disposal
• Unfasten ties• Peel gown away from neck and shoulder• Turn contaminated outside toward the
inside• Fold or roll into a bundle• Discard
• Untie the bottom, then top, tie• Remove from face• Discard
Lift the bottom elastic over your head first Then lift off the top elastic Discard
Cost Availability Training Appropriate Use Appropriate Disposal
Cost Availability Training Appropriate Use Appropriate
Disposal
Correct PPE Use
Protect yourself and others
2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings . CDC.
WHO. Standard Precautions in HealthCare. Oct 2007. Infection Control