4 - Personal Protective Equipment (PPE)

PPE products you might need in the care home:• gloves• aprons• masks• eye protection

PPE for visitors

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:

Reusable PPE items, for example non-disposable goggles, face shields and visors, should have a decontamination schedule with responsibility assigned.

Read further information on best practice for PPE in Appendix 16.

 

Donning (putting on) personal protective equipment (PPE) 

The order for putting on PPE is:

  1. apron or gown
  2. surgical mask
  3. eye 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 protection (if worn)
  4. surgical mask

Note:

Always carry out hand hygiene immediately after taking off PPE.

All PPE should be removed before leaving the area and disposed of as healthcare waste

Resources

A video demonstrating the order for donning and doffing PPE is available. 

The correct order for donning, doffing and disposal of PPE for healthcare workers from NHS National Services Scotland on Vimeo.

 

A poster showing the order for putting on and removing PPE is available to print.

 

Select image for full size version

Putting on and taking off PPE step by step

Gloves

Gloves should be:

 

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 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.

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Aprons and gowns

Aprons should be:

The choice of apron or gown is based on an individual risk assessment and anticipated level of blood/body fluid exposure. Routine sessional use of gowns/aprons is not permitted.

Eye/face protection

Eye/face protection (including full face visors) should:

Note:

Eye/face protection (including visors) should not be touched when worn.

Facial accessories such as piercings or false eyelashes should not be worn when using eye/face protection.

Regular glasses or safety glasses are not considered eye protection.

Fluid Resistant Type IIR surgical face masks (FRSM)

Fluid Resistant Type IIR surgical face masks should be:

If you are using droplet precautions, you should always wear a Type IIR surgical face mask as well as the full-face visor (droplet precautions will be discussed further in Chapter 2 Transmission Based Precautions).

Transparent face masks

Transparent face masks may be used to aid communication with residents where required.

Transparent face masks should:

and

Resources

Read the aerosol generating procedures literature review and surgical face masks literature review for further information regarding the evidence base.

 

 

See appendix 11 for further information.

 

PPE for visitors 

At times, PPE may be offered to visitors to protect them from acquiring a transmissible infection. If a visitor declines to wear PPE when it is offered then this should be respected, and the visitor should not be refused entry to the care home. PPE use by visitors cannot be enforced and there is no expectation that staff monitor PPE use amongst visitors. Below is the PPE which should be worn where it is appropriate to do so and when the visitor chooses to do so.

Visitors do not routinely require PPE unless they are providing direct care to residents they are visiting. 

Table 1 is a guide to PPE for use by visitors if delivering direct care.

Table 1: PPE for use by visitors

IPC Precaution

Gloves

Apron/Gown

Face covering/mask

Eye/face protection

Standard Infection Control Precautions (SICPs)

Not required*1

Not required*2

Where splash/spray to nose/mouth is anticipated during direct care

Not required*3

Transmission Based Precautions (TBPs)

Not required*1

Not required*2

If within 2 metres of resident with suspected or known respiratory infection

If within 2 metres of resident with suspected or known respiratory infection

*1 Unless providing direct care which may expose the visitor to blood and/or body fluids, for instance toileting.

*2 Unless providing care resulting in direct contact with the resident, their environment or blood and/or body fluid exposure, for instance toileting, bed bath.

*3 Unless providing direct care and splashing/spraying is anticipated.

 

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