DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
RISK ASSESSMENT
- Assess risk of transmission of the micro-organism to patient or healthcare worker
- Assess risk of contamination of the healthcare workers clothing or skin by the patient’s blood or body fluid
- Assess suitability of the personal protective equipment for proposed use
- Follow current COVID 19 guidelines
GLOVES
When
- Wear disposable gloves for:
- Invasive procedures
- Performing aseptic non touch technique (ANTT)
- Contact with sterile sites, non-intact skin or mucous membranes
- Managing surgical wounds
- Anticipated contact or exposure to blood, body fluids, secretions and excretions
- Handling sharp or contaminated instruments
- Application of topical preparations
- Contact with cytotoxic agents
- Contact with chemicals
- When decontaminating equipment
How
- Put gloves on immediately before required and remove as soon as activity is completed
- Following removal of gloves, decontaminate hands
- Change gloves between care activities for different patients or between different care activities on the same patient
- gloves are single-use items
Choice
- Use non-latex gloves
- Choice of sterile or non-sterile will depend on the intended procedure
- A range of CE-marked gloves of different sizes and suitable for the task available in all clinical areas
GOWNS AND PLASTIC APRONS
Fluid-repellent gowns
- Risk of extensive splashing of blood and body fluids
- e.g. major trauma or during major surgical procedures, or for certain infections
- Wear a full-body fluid-repellent gown
Plastic aprons
- Wear a disposable plastic apron if:
- clothing or uniform may be exposed to blood, body fluids, secretions and excretions
- caring for patients with certain infections e.g. Clostridium difficile
- Change plastic aprons between patients and between different care activities on the same patient
- aprons are single-use items
MASKS, EYE AND FACE PROTECTION
- Wear depending on:
- known/suspected infectious status of the patient
- presenting symptoms
- task involved
- risk of splashing to eyes and face
Splash and droplets
Droplets
- Droplets are expelled from the respiratory tract during coughing and sneezing
- The minimum distance for droplet precautions is 2 m
- the minimum not an absolute distance
Airborne transmission
- Coughing, sneezing and aerosol generating procedures (e.g. nebulisers) generate aerosol particles from respiratory tract
- can remain in the air for long periods of time
- be carried over long distances by air currents
Surgical face masks (IIR)
- Provide a barrier to splashes and droplets impacting on the wearer’s nose, mouth and respiratory tract
- Must be fluid resistant to protect against infection
- Do not provide protection against airborne (aerosol) particles
FFP3 (respirator) masks
- Provide respiratory protection from airborne transmitted organisms and during aerosol generating procedures;
Valved or non-valved FFP3 mask?
- When sterility directly over the sterile field is required, wear a non-valved mask (filters expired air)
- e.g. in theatres/surgical settings or when undertaking a sterile procedure
- valved are more comfortable for the wearer but do not filter the expired air
Fit testing
- Before using a FFP3/respirator mask, a competent person will fit test to verify the user
- has a mask suitable for their face shape
- puts it on with no gaps between the mask and their face for air to pass through unfiltered
- those results are recorded and available
- informs the user to only wear the type and make/model of mask fitted
- Undertake fit testing every 2 years and in the following circumstances:
- necessary to change to another type, make/model of face piece
- wearer has lost or gained weight
- wearer has undergone substantial dental work or developed facial imperfections such as scars, moles around the face seal
- new facial piercings
Fit check
- Each time a FFP3/Respirator mask is worn, the wearer fit checks by:
- covering the front of the mask with clean hands
- for a non-valved mask, exhaling sharply
- for a valved mask, inhaling sharply
- if airflow is present around the nose, readjust the nosepiece, if air flows around the edges of the mask readjust the headbands
- A successful fit check is when there is no air leaking from the edges of the mask
- If a successful check cannot be achieved, remove, and refit the mask
- If you still cannot obtain a successful fit check, do not enter the work area
Loose fitted powered respirator with hoods/helmets particulate filter
- Loose fitted powered respirator with hoods/helmets are an alternative to tight fitting FFP3 mask e.g. when fit test cannot be achieved
- Use a model available approved by Infection Prevention and Health and Safety
- Mask fit testing is not required for air powered respirators
- User requires education on safety and maintenance checks, donning and doffing, filter change, decontamination and safe storage
- Expired air not filtered
Protective eyewear and face shields
- Wear if:
- secretions, excretions or blood may be splashed or sprayed towards the face
- delivery procedures, surgical/invasive procedures, severe trauma or other patient care activities, e.g. suctioning, chest physiotherapy
- resuscitation/intubation and exubation of a patient with suspected/confirmed serious infection e.g. meningitis
- Regular spectacles are not eye protection
REMOVAL OF PERSONAL PROTECTIVE EQUIPMENT
- Remove personal protective equipment in the following sequence
- gloves
- apron/gown
- decontaminate hands
- eye protection
- mask/respirator
- decontaminate hands
- Masks are single-use items
- discard in the clinical waste bins