PPE Quick Links:
Nitrile Gloves | Face Masks/Shields
What is personal protective equipment?
Personal protective equipment, commonly referred to as "PPE", is equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. These injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. PPE is commonly used in health care settings such as hospitals, doctor's offices and clinical labs. Personal protective equipment may include items such as gloves, safety glasses or face shields, protective shoes or shoe coverings, earplugs or muffs, hard hats, respirators, face masks, coveralls, vests and full body suits.When used properly, PPE acts as a barrier between infectious materials such as viral and bacterial contaminants and your skin, mouth, nose, or eyes. The barrier has the potential to block transmission of contaminants from blood, body fluids, or respiratory secretions. If PPE is to be used, a PPE program should be implemented. This program should address the hazards present; the selection, maintenance, and use of PPE; the training of employees; and monitoring of the program to ensure its ongoing effectiveness.
Protective clothing is designed to protect users from unintended dermal exposures that could lead to the development of an adverse health hazard. Depending on the hazard different types of protective clothing must be developed to create a barrier that protects workers from occupational hazards that could affect them through dermal contact. There are different considerations that must be taken into account when selecting the appropriate protective clothing including the hazard, the material, design, durability comfort and functionality. Usually, these garments are designed to protect workers from chemicals and other body fluids such as urine, saliva, blood, etc. It is important to take into account the shape, size of microorganisms, chemical properties of the fabric such as repellency, or pore size, and external factors that may affect the effectivity of the garment such as temperature or physical and chemical conditions. The following websites provide information on the correct selection and use of protective clothing.
What can be done to ensure proper use of personal protective equipment?
Employers are required to train each worker required to use personal protective equipment to know:
- When it is necessary
- What kind is necessary
- How to properly put it on, adjust, wear and take it off
- The limitations of the equipment
- Proper care, maintenance, useful life, and disposal of the equipment
It should fit comfortably, encouraging worker use. If the personal protective equipment does not fit properly, it can make the difference between being safely covered or dangerously exposed. Effective use of PPE includes properly removing and disposing of contaminated PPE to prevent exposing both the wearer and other people to infection.
When to Wear PPE
Legally, the employer must provide PPE, ensure that the employee uses and must clean, repair, and replace this equipment as needed. You as the employee have the right to have PPE available to complete your job duties.The worker often must decide on their own when to wear PPE because exposure is likely. If exposure seems reasonably likely, you have the right to protect yourself with PPE.
Gloves should be worn when:
- It can reasonably be anticipated that the employee may have hand contact with blood, OPIM (other potentially infectious materials), mucous membranes and non-intact skin
- Performing all vascular access procedures or procedures involving uncontained blood, such as finger or heel sticks
- Gloves must be changed between patients (CDC, 2013)
Single use gloves cannot be washed or decontaminated for reuse. Utility gloves worn by engineering or housekeeping may be decontaminated if they are not compromised. They should be replaced when they show signs of cracking, peeling, tearing, puncturing, or deteriorating.
Traditionally, latex gloves are used to avoid contact with blood or OPIM. However, some workers are allergic to latex or vinyl. In most circumstances, nitrile or other glove alternatives may be used in place of latex gloves. Employers are required to provide non-latex alternatives to employees with sensitivities to latex and other materials. Sterile or nonsterile gloves are also available as PPE and dictated by the procedure.
| Dos and Don'ts of Glove Use | |
|---|---|
| Do | Don't |
| Work from clean to dirty | Touch your face |
| Limit opportunities for touch contamination | Adjust the PPE with a contaminated glove |
| Double glove if changing a very soiled bed/bowel movement | Touch environmental surfaces except as necessary during patient care |
| Change gloves if torn, heavily soiled and between patients | Wash or reuse gloves |
Employees should wear eye and mouth protection such as goggles and masks, glasses with solid side shields, and masks or face shields when splashes, sprays, splatters, or droplets of blood or OPIM pose a hazard to eyes, nose, or mouth.
Gowns, aprons, surgical caps and hoods, shoe covers, or boots are needed when splash, spray, or gross contamination is expected. This may occur, for example, during labor and delivery, surgery and procedures with anticipated blood splash may occur.
Personal protective clothing and equipment must be appropriate for the level of protection needed for the expected exposure. For example, gloves would be sufficient for a laboratory technician who is drawing blood, whereas a pathologist conducting an autopsy would need considerably more protective clothing. Personal protective equipment may be required during the care of any patient, so it must be routinely available in patient-care areas, not just on isolation carts. You may need to wear a mask and eye protection during the care of a patient on Standard or Universal Precautions. Availability of PPE is required by the OSHA Standard. If you are not sure where to obtain it, ask your employer.
What PPE to Wear
Knowing what to wear for each different type of isolation is important for your protection. Factors influencing PPE selection include the fit, the type of exposure anticipated, durability, and appropriateness for the task.
| Airborne | Contact | Droplet |
|---|---|---|
| Gloves | Gloves | Gloves |
| Gown | Gown | Gown |
| N95 Respirator | Goggle/Face shield if splash anticipated, but not needed for standard contact isolation | Goggles/Face shield |
| What PPE would you wear for these patient encounters? | |
|---|---|
| Encounter | Type of PPE |
| Suctioning oral secretions? | gloves and mask/goggles or a face shield |
| Transporting a patient in a wheelchair? | generally, none |
| 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 and generally a gown |
| Irrigating a wound? | gloves, gown, and mask/goggles or a face shield |
| Taking vital signs? | generally, none |
Exception
The employer should ensure that the employee uses appropriate PPE unless the employer shows that the employee temporarily and briefly declined to use PPE when, under rare and extraordinary circumstances, it was the employee's professional judgment that in the specific instance its use would have prevented the delivery of healthcare or public safety services or would have posed an increased hazard to the safety of the worker or co-worker.
When the employee makes this judgment, the circumstances shall be investigated and documented in order to determine whether changes can be instituted to prevent such occurrences in the future. In other words, if using PPE would increase danger to the person receiving care or to the worker, then the worker may decline to use the PPE, but situations like this must be reported and investigated, and are rare.
Decontaminating and Disposing of PPE
Employees must remove personal protective clothing and equipment before leaving the work area or when the PPE becomes contaminated. If a garment is penetrated, workers must remove it immediately or as soon as feasible. Used protective clothing and equipment must be placed in designated containers for storage, decontamination, or disposal.
While use of PPE cannot prevent all exposures, wearing it properly and when needed can greatly reduce potential exposure to all bloodborne pathogens. The sequence for removing PPE is:
Gloves —> Goggles —> Gown —> Mask