personal protective equipment: protecting yourself and the community from infectious disease...

Personal Protective Equipment:

Protecting Yourself and the Community from Infectious Disease

Presented by: The Massachusetts Department of Public Health

The Local Public Health Institute of Massachusetts

Fall 2005

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The purpose of this training is…

To promote a common-sense approach to infection control in a community setting

To present basic, introductory information about the use of personal protective equipment for protection against and control of infectious diseases

NOT to create new policy or regulations concerning the proper use of personal protective equipment

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Defining PPE

Personal Protective Equipment (PPE) is specialized clothing or equipment worn for protection against dangerous or infectious materials

PPE prevents contact with an infectious agent, or body

fluid that may contain an infectious agent, by creating a barrier between the potentially infectious material and the public health responder

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Using PPE

Hand Hygiene

Respiratory Hygiene

Standard Precautions

ExpandedPrecautions

Other Uses of PPE

Final Quiz

ComprehensiveScenario

PPE Basics

Defining Additional Terms

“Community setting” is any setting outside a hospital or established health care clinic in which a public health responder carries out medical interventions

A “public health responder” is a public health professional (either medical or non-medical) serving in a public health capacity

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Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


PPE Basics

Defining Disease Transmission

The spread of infectious disease requires a:

Source of infection Route of transmission Host susceptible to the infection

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Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


PPE Basics

Defining Disease Transmission Infectious diseases are spread through one or more of the following

routes of transmission: Contact (skin, fecal-oral, blood)

Hepatitis B Droplet (coughing, sneezing, talking: droplets are large and only

travel within 3 feet) Meningoccocal Meningitis

Airborne (coughing, sneezing: particles are small and travel more than 3 feet)

Measles Common vehicle (food, water, objects)

Salmonella Vector-borne (mosquitoes, ticks)

Lyme Disease

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Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


PPE Basics

Controlling Disease Transmission

The spread of infectious disease can be controlled by:

Wearing PPE Practicing Hand Hygiene Promoting Respiratory Hygiene Following Standard Precautions Following Expanded Precautions, as necessary

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Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


PPE Basics

Wearing PPE

PPE acts as a barrier between you and: Your client Objects in your client’s environment Infectious agents, substances, or materials

Wear PPE to: Stop the spread of illness/infection Protect your health Protect your client’s health Protect your family’s health Protect the community’s health

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Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


PPE Basics

Available PPE

A variety of PPE is available for your protection, including: Gowns, Aprons, Cover-All Suits Masks Respirators Goggles Face shields Gloves Shoe covers (booties) Hair covers

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Donning PPE

Don PPE in the following order:

1. Gown (or apron/cover-all suit) 2. Shoe and/or hair covers (when worn)3. Mask/Respirator4. Goggles (or face shield in lieu of mask

and goggles)5. Gloves

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Donning Gowns

The first piece of PPE you should

put on is the gown.

1. Make sure the opening is in the back

2. Secure at the neck and waist

3. If the gown is too small, use two gowns:

Gown #1 ties in front Gown #2 ties in back

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Click on Movie to Play

PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

About Masks

There are several types of masks that can be worn to prevent the spread of infectious disease

Masks are not respirators Masks vary by:

Shape (rectangular, round) Method of securing (elastic, ties)

Select a mask you are comfortable wearing and one that provides an adequate amount of protection

Use common sense when donning and removing masks, as the procedure may vary based on the method of securing the mask to your face

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

About Masks, Continued

This training demonstrates the use of one type of mask

Other common types of masks include:

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Elastic tie Cloth ties

Donning Masks

1. Place mask over your mouth, nose and chin

2. Fit the flexible nose piece over nose bridge

3. Secure with ties or elastic

4. Adjust to fit

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

About Respirators

There are several types of respirators that can be worn to control the spread of infectious disease

Respirators vary by: Size (small, medium, large) Shape (oval, round) Level of respiratory protection offered (N95

versus N100)

Unlike masks, respirators must be fit-tested before use to ensure they fit your face properly

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Fit-Testing Respirators

Respirators must have a mask-to-face seal and must be checked annually to ensure adequate protection

Fit-testing is the procedure used to ensure a mask-to-face seal and involves tests to make sure there is no air leakage between the mask and the face

Contact your regional Health Educator for additional information about respirator fit-testing

Remember: NEVER use a respirator that has not been fit-tested for your face

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

About Respirators, Continued

This training demonstrates the use of one type of N95 respirator

Other common types or variations of the N95 respirator include:

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

N95 N100 N95

Donning Respirators

1. Select a fit-tested respirator, such as an N-95 respirator mask

2. Place the respirator over your nose, mouth and chin

3. Fit the flexible nose piece over your nose bridge

4. Secure on your head with elastic

5. Adjust to fit6. Perform a fit check:

Inhale: Respirator should collapse

Exhale: Check for leakage around face

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Donning Goggles

1. Position goggles over eyes and secure to the head using the ear pieces or headband

2. Adjust to fit comfortably

*If wearing a face shield instead of a mask and goggles, position the face shield over face and secure on brow with headband

Remember: Eyeglasses alone do NOT provide adequate protection

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Donning Gloves

1. Put gloves on last

2. Select the correct type and size

3. Insert hands into gloves

4. If you are wearing a gown, tuck the gown cuffs securely under each glove

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Removing PPE

1. Remove PPE in an area where you are not in danger of exposure to the infectious agent

Separate room Porch or garage Breezeway or other entryway

2. Identify “clean” and “contaminated” areas of PPE Clean areas: Have NOT been in contact with

infectious agent Contaminated areas: HAVE been in contact with

infectious agent

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Removing PPE3. To limit self-contamination, remove PPE in the following

order:1. Gloves2. Goggles (or face shield in lieu of mask and goggles)3. Gown (or apron/cover-all suit)4. Shoe and/or hair covers (when worn)5. Mask/respirator

4. Discard PPE immediately and properly so as not to contaminate the “clean” area

5. Perform hand hygiene immediately after removing PPE

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Removing Gloves

1. Remove your gloves first 2. Hold the outside edge

near your wrist3. Peel the glove away from

your hand, turning the glove inside-out

4. Hold the glove in the opposite gloved hand

5. Slide your ungloved finger under the wrist of the remaining glove

6. Peel off from the inside, creating a bag for both gloves

7. Discard in a plastic bag

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Removing Gowns

1. Unfasten the ties2. Peel the gown away

from your neck and shoulder

3. Turn the contaminated outside toward the inside

4. Fold or roll into a bundle

5. Discard in a plastic bag

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PPE Basics

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Using PPE

Welcome toSTANDARD PRECAUTIONS

This section includes:

An overview of Standard Precautions PPE for Standard Precautions

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Overview

Most of the time you respond in a public health role, you will not have a confirmed diagnosis for the person you might be dealing with

Use Standard Precautions regardless of diagnosis

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene

ExpandedPrecautions

Other Uses of PPE

Final Quiz



PPE for Standard Precautions: Determining What to Wear

Decisions about PPE use are determined by the type/level of contact you will have with the client

To determine what PPE to wear, ask yourself: Will I be touching the client or potentially

contaminated objects in their environment? Is there a likelihood of blood or body fluids

spraying or splashing? Is the client coughing, sneezing, or vomiting? Do

they have diarrhea?

When in doubt, applying the most conservative level of PPE is the best protection

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene

ExpandedPrecautions

Other Uses of PPE

Final Quiz



PPE for Standard Precautions Use:

Gloves: When you may touch a client in a way that might lead to exposure to blood or body fluids or touch objects in their environment that may be contaminated, and/or

Gowns: When there is a risk of your clothing or exposed skin coming in contact with anything wet or weeping, and/or

Mask and goggles or a face shield: When there is a risk of being splashed or sprayed with blood or body fluids

Practice: Hand hygiene and promote respiratory hygiene (if

working with clients who have respiratory symptoms) as a regular part of Standard Precautions

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene

ExpandedPrecautions

Other Uses of PPE

Final Quiz



What PPE Would You Wear…

When working with a client: With a skin infection, or an open wound? Who has incontinent diarrhea? For whom you deliver food and mail without

interaction?

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene

ExpandedPrecautions

Other Uses of PPE

Final Quiz



Welcome toEXPANDED PRECAUTIONS

This section includes:

An overview of Expanded Precautions A description of Contact and Droplet Precautions,

and Airborne Infection Isolation PPE for Expanded Precautions Scenario demonstrating use of Expanded

Precautions

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


Overview

Expanded Precautions are used in addition to Standard Precautions to prevent the spread of infection when you know or suspect: A client’s diagnosis What illness or infectious agent you may be

exposed to The client’s symptoms lead to a risk of contact

with blood or body fluids

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

Overview

Expanded Precautions is the use of PPE in

addition to Standard Precautions

Expanded Precautions include: Contact Precautions Droplet Precautions Airborne Infection Isolation

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

PPE for Expanded Precautions: Determining What to Wear

Decisions about PPE use are determined by the diagnosis or suspected diagnosis of the client, the client’s symptoms, or type of infectious agent or illness you will encounter

To determine what PPE to wear, ask yourself: What is the client’s diagnosis or suspected

diagnosis? Is the client infectious? What is the infectious agent or illness I may

encounter? What is the mode of transmission of this agent or

illness? Does the client have symptoms which lead to

increased likelihood of transmission?

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

PPE For Expanded Precautions

In addition to Standard Precautions, and based on your assessment of the mode of transmission of the agent or illness you may encounter, it may be necessary to follow:

Contact Precautions Wear gown and gloves for all contact with client

and/or objects in the client’s environment Droplet Precautions

Wear appropriate respiratory protection within 3 feet of client

Airborne Infection Isolation Wear appropriate respiratory protection (e.g.,

N-95 respirator) when entering client’s environment

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

What Type of Expanded Precautions Would You Follow When…

Visiting with a client who has been diagnosed with: Hepatitis A and is incontinent/diapered? Influenza? Pulmonary tuberculosis? SARS?

What PPE would you wear?

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

What Type of Expanded Precautions Would You Follow When…

Visiting with a client who has been diagnosed with: Hepatitis A and is incontinent/diapered

Answer: Contact Precautions - Gown, gloves Influenza

Answer: Droplet Precautions - Appropriate respiratory protection (e.g., mask)

Pulmonary tuberculosis Answer: Airborne Infection Isolation - Appropriate respiratory protection (e.g., N-95 respirator)

SARS Answer: Contact Precautions, Droplet Precautions, Airborne Infection Isolation - Gown, gloves, goggles, appropriate respiratory protection (e.g., N-95 respirator)

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

Other Uses of PPE

Sometimes, PPE may be used to protect public health responders from contact with a bioterrorism (BT) agent or hazardous material, such as one encountered during a bioterrorist event or other public health emergency

PPE used for protection from exposure to biological agents may not protect against exposure to chemical agents

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Other Uses of PPE

Final Quiz


ExpandedPrecautions

Other Uses of PPE In these situations, you may hear terms such as:

Level A, B, C and D PPE Types of PPE used to protect against exposure to

hazardous materials and bioterrorism (BT) agents Special training needed to use levels A, B, and C

Hot, Warm and Cold Zones Terms to identify level of danger of a particular

site for control purposes during a chemical, biological, or radiological event

Hazmat Teams Teams that are highly trained and fully equipped

to respond to a situation involving a hazardous material

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


Final Quiz


ExpandedPrecautions

Other Uses of PPE

Other Uses of PPE

For more information about the PPE required for protection against hazardous materials and infectious agents, please visit:

http://www.cdc.gov/niosh/topics/emres/ppe.html

Future training opportunities may be available on this topic

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PPE Basics

Using PPE

Hand Hygiene

Respiratory Hygiene


ExpandedPrecautions

Final Quiz


Other Uses of PPE

Thank You

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Respiratory Hygiene


ExpandedPrecautions

Other Uses of PPE

Final Quiz


personal protective equipment: protecting yourself and the community from infectious disease...

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