Deciding which PPE to use

Before doing any procedure or task staff should risk assess any likely exposure to blood and/or body fluids and ensure PPE is worn that provides adequate protection against the risks associated with the procedure or task being undertaken.

All PPE should be:

• located close to the point of use
• stored in a clean and dry area to prevent contamination until needed for use
• within expiry dates
• single-use only items unless specified as reusable by the manufacturer
• checked for any damage or defects before donning
• changed immediately after individual use and/or following completion of a procedure or task
• disposed of after use into the correct waste stream 

Reusable PPE items, for example non-disposable goggles, face shields or visors must be cleaned/decontaminated once removed or placed within a designated container for subsequent cleaning/decontamination with decontamination schedules in place and responsibility assigned.

Gowns, headwear and footwear are unlikely to be required as part of the PPE ensemble within a care home setting. Please refer to the NIPCM for further guidance on use if required.

Disposable items of PPE you might require at the point of care delivery. • gloves• aprons• gown• fluid resistant surgical masks (FRSM)• eye/face protection

See PPE for visitors

Donning (putting on) personal protective equipment (PPE) 

The order for putting on PPE is:

1. apron or gown
2. fluid resistant surgical mask (FRSM)
3. eye/face protection (where required)
4. gloves

Doffing (taking off) personal protective equipment (PPE) 

It is important that PPE is removed in the correct order.

The order for taking off PPE is:

1. gloves
2. apron or gown
3. eye/face protection (if worn)
4. fluid resistant surgical mask (FRSM)

Note:

Always carry out hand hygiene immediately after taking off PPE.

If using eye and face protection an extra hand hygiene step should be carried out after removing the apron or gown and before removing eye and face protection.

Once all PPE is removed it should be disposed of as healthcare waste and hand hygiene should be performed.

Resources

A poster showing the donning (putting on) and doffing (removing) of PPE is available to print.

 

Gloves

Gloves should be:

• worn when it is likely or anticipated that you will be exposed to blood,  body fluids (including but not limited to secretions and/or excretions), non-intact skin, mucous membranes, lesions and/or vesicles, hazardous drugs, and chemicals for example cleaning agents
• single-use and should be donned (put on) immediately prior to exposure risk and should be doffed (taken off) immediately after each use or upon completion of a task
• appropriate for use, fit for purpose and well-fitting. The glove selection chart can help you select the correct gloves
• changed if damaged or a perforation or puncture is suspected

 

Note:

Using gloves reduces the risk of contamination but does not remove all risk.

Gloves should not be used instead of carrying out hand hygiene.

Gloves should not be worn inappropriately in situations such as to go between residents, move around a care area or whilst at workstations (on the telephone  or computer).

Gloves are single use disposable items and should never be decontaminated or cleaned with hand rub or by washing with cleaning products.

 

Use the glove selection chart to support you to select the correct glove type.

 

Aprons and gowns

Selection of aprons or gowns for use in health and care settings should be based on an assessment of the task to be undertaken, and the anticipated levels of blood or body fluid exposure.

Aprons should be:

• disposable
• fluid repellent
• used to protect the uniform, workwear or clothes to prevent exposure or contact with another person’s:
  • blood or body fluids (including urine, faeces, vomit, nasal discharge, wounds, sores)
  • mucous membranes (including nose and mouth)
  • rashes (for example confirmed or suspected scabies)
  • leaking vesicles (for example confirmed or suspected shingles)
• used to protect uniform, workwear or clothes when exposure or contact with hazardous drugs, chemical or cleaning products is likely
• used to protect uniform, workwear or clothes when contact or exposure or handling of used, soiled, or infectious linen/laundry is likely
• to protect uniform, workwear or clothes when providing direct care to a resident during assisted toileting, or eating
• regarded as single use items which should never be reused (one resident, one task, one apron)

Eye/face protection

Eye/face protection should:

• be worn when there is an anticipated risk of splashing or spraying of blood or bodily fluids 

Note:

Eye/face protection should not be touched when worn or worn around the neck or on top of the head when not in use.

Eye/face protection should be compatible with other items of PPE and worn in accordance with manufacturer’s instructions.

Prescription eyeglasses and contact lenses should not be considered a form of eye/face protection.

Fluid resistant surgical face masks (FRSM)

Fluid resistant surgical face masks should be:

• worn if splashing or spraying of blood or body fluids onto the nose and mouth is anticipated/likely
• well-fitting with an integral nose clip or wire and an easily identifiable inner and outer surface

Fluid resistant surgical face masks should be removed or changed:

• between resident contact 
• at the end of a procedure/task
• if the integrity of the mask is compromised because it is damaged, damp, wet, soiled or visibly contaminated with blood or body fluids 

Transparent face masks

Transparent face masks may be used

• when there are communication barriers, if they meet the specifications of BS EN 14683:2025

Resources

Read the surgical face masks literature review for further information regarding the evidence base.

 

 

See appendix 11 for FRSM use during the application of Transmission Based Precautions (TBPs)

 

SICPs PPE Summary Table

Gloves	Aprons	Gowns	Eye/Face protection	Fluid Resistant Surgical Masks (FRSM)	Respiratory Protective Equipment (RPE)
When it is anticipated that there is contact with or exposure to blood, bodily fluids, secretions, excretions, non-intact skin or mucous membranes or contaminated surfaces. Use gloves in accordance with Appendix 5 – Glove use and selection.	When in direct care contact with a resident or their immediate environment.	When there is a risk of extensive splashing of blood and/or other body fluids. Worn when a disposable apron provides inadequate cover for the procedure or task being performed.	When there is an anticipated risk of splashing and/or spraying of blood or bodily fluids.	When splashing or spraying of blood, body fluids, secretions, or excretions onto the respiratory mucosa (nose and mouth) is anticipated/likely.	Not required.

PPE for visitors 

Visitors are not routinely required to wear PPE unless they are providing direct care to the resident they are visiting.

If the need for PPE is identified, staff should provide advice on its correct use.

If, following an explanation of potential risks, a visitor declines to wear PPE when offered, then this should be respected, and the visit must not be refused. There is no expectation for staff to monitor the use of PPE by visitors. The table below shows the PPE which should be worn where appropriate and when the visitor chooses to do so. 

PPE use for care home visitors

Gloves	Aprons	Fluid Resistant Surgical Masks (FRSM)	Goggles, visors, face shields for eye/face protection
If providing direct care which exposes them to blood and/or body fluids for example assisted toileting or feeding.	To protect clothing if they intend to provide direct care which will expose them to blood/ or body fluids, or there is likely to be splashing of blood or bodily fluids during care delivery.	To protect their nose and mouth from likely splash/spray of blood or body fluids.	To protect their face and eyes from any likely splash or spray from blood or body fluids.

Read the PPE literature reviews to find out more information about the evidence base for PPE use.