Protecting staff and patients from infection is vital so all staff who may have to use personal protective equipment must know how to use and remove it correctly

Introduction

The aim of using personal protective equipment (PPE) is to protect against health or safety risks at work. The epic3 (Loveday et al, 2014) evidence-based guidelines on infection prevention and control state that selection of PPE should be based on an assessment of the:

1. Risk of transmission of micro-organisms to the patient or carer;

2. Risk of contamination of the health professional’s clothing or skin by the patient’s blood or body fluid or respired aerosols or droplets;

3. Suitability of the equipment for the proposed use - does it fit, is it CE marked, do PPE items fit together?

Before using PPE, staff should be educated and their competence assessed in the assessment of risk, and selection and use of PPE, as well as the use of standard precautions. It is important to assess whether the selected PPE will be effective - for example, staff using respirators will need to be “fit tested” to ensure Disposable Face Masks are a correct and safe fit (NHS England and Public Health England, 2013a).

Using unfamiliar PPE can increase the risk of self-contamination due to lack of skill and confusion in the correct removal method. PPE should not be used, nor tasks undertaken that require its use, until staff are confident and competent in doing so.

When should PPE be used?

Gloves

Disposable Gloves are single-use items and should be used for invasive procedures including contact with sterile sites, non-intact skin or mucous membranes, and for all activities that have been assessed as carrying a risk of exposure to blood, body fluid or infectious respired aerosols or droplets. They must be put on immediately before an episode of patient contact or treatment; they must not be used to open doors and collect equipment before patient contact.

Gloves should be:

1. Used when handling sharps or contaminated devices (Loveday et al, 2014) - micro-organisms can survive on objects, or “fomites”, and become a risk for transmission of infection;

2. Removed as soon as the episode of care is completed - hands must be decontaminated immediately after glove removal;

3. Changed when soiled - they must not be washed or decontaminated with alcohol products between procedures and should be changed between caring for different patients.

Since the effect of alcohol hand gels on PE Gloves material has not been tested, the integrity of gloves decontaminated in this way cannot be guaranteed.

Aprons and gowns

Aprons are single-use items and must be worn when in close contact with patients, materials or equipment that pose a risk of contamination with blood or body fluids (Loveday et al, 2014). Fluid-repellent Disposable Gowns must be worn when there is an extensive risk of the splashing of blood or body fluid onto the skin or clothing of health workers.

Staff should ensure aprons/gowns are:

• Changed when visibly soiled - although it takes some time for fluid to seep through fluid-repellent Isolation Gowns (strikethrough), they are not waterproof;

• Worn for one procedure or episode of patient care only.

Non-disposable PPE should be sent for appropriate decontamination (Loveday et al, 2014).