PE RSONAL PROT ECT IVE EQUIPMENT
domestic waste/offensive (non-infectious) or infectious clinical waste.
l Discarded if damaged or contaminated l Safely doffed (removed) to avoid self- contamination.
l Decontaminated after each use following manufacturers’ guidance if reusable PPE is used, specifically non-disposable goggles/ face shields/visors.
Gloves must: l Be worn when exposure to blood and/ or other body fluids, non-intact skin or mucous membranes is anticipated or likely.
l Be changed immediately after each patient and/or after completing a procedure/task even on the same patient.
l Be put on immediately before performing an invasive procedure and removed on completion.
l Not be decontaminated with alcohol-based hand rub (ABHR) or soap between use.
NB. Double gloving is not recommended for routine clinical care of COVID-19 cases.
Aprons must be: l Worn to protect uniform or clothes when contamination is anticipated or likely.
l Worn when providing direct care within 2 metres of suspected/confirmed COVID-19 cases.
l Changed between patients and/or after completing a procedure or task.
Full body gowns or fluid repellent coveralls must be: l Worn when there is a risk of extensive splashing of blood and/or body fluids.
l Worn when undertaking aerosol generating procedures.
l Worn when a disposable apron provides inadequate cover for the procedure or task being performed (surgical procedures).
l Changed between patients /individuals and immediately after completing a procedure or task.
Eye or face protection
(including full-face visors) must: l Be worn if blood and/or body fluid contamination to the eyes or face is anticipated or likely and always during aerosol generating procedures.
l Not be impeded by accessories such as piercings or false eyelashes.
l Not be touched when being worn. Conclusion
Fluid resistant surgical face mask (FRSM Type IIR) masks must: l Be worn with eye protection if splashing or spraying of blood, body fluids, secretions or excretions onto the respiratory mucosa (nose and mouth) is anticipated or likely.
l Be worn when providing direct care within 2 metres of a suspected/confirmed
Minismising harm to health and social care staff at this point in the pandemic has got to be high up on the agenda of most facilities in order to protect their most precious resource – their staff. Appropriate PPE must continue to be available for all staff whenever they need it and we must keep our eyes open for the next version of this guidance which
16 l
WWW.CLINICALSERVICESJOURNAL.COM Least effective Figure 2: Hierarchy of controls COVID-19 case.
l Be well-fitting and fit for purpose, fully cover the mouth and nose (manufacturers’ instructions must be followed to ensure effective fit and protection).
l Not be touched once put on or allowed to dangle around the neck be replaced if damaged, visibly soiled, damp, uncomfortable or difficult to breathe through.
Surgical face masks Type II must be: Worn for extended use by healthcare workers when entering the hospital or care setting (Type IIR is also suitable). Type I are suitable in some settings, refer to the resource section for country specific guidance.
Headwear/footwear: l Headwear is not routinely required in clinical areas (even if undertaking an AGP) unless part of theatre attire or to prevent contamination of the environment such as in clean rooms.
l Headwear worn for religious reasons (for example, turban, kippot veil, headscarves) are permitted provided patient safety is not compromised – these must be washed and/or changed between each shift or immediately if contaminated and comply with additional attire in, for example, theatres.
l Foot/shoe coverings are not required or recommended for the care of COVID-19 cases.
will surely advocate using FFP3 masks for any interaction where there is a patient with confirmed COVID-19 or the COVID-19 status of the patient or family member is unknown but considered to be ‘a risk’.
CSJ
NB. PPE may restrict communication with some individuals and other ways of communicating to meet their needs should be considered.10
References 1 Public Health England. Covid-19: Guidance for maintaining services within health and care settings. Infection Prevention and Control recommendations Version 1.2 June 2021
2 RCN Position on Personal protective equipment (PPE) for COVID-19 accessed at RCN Position on Personal Protective Equipment (PPE) for COVID-19, Royal College of Nursing
3 BMA calls for urgent review of PPE guidance as provision still inadequate and healthcare workers at serious risk. January 2021
https://www.bma.org.uk/ bma-media-centre
4 Fresh Air NHS Open Letter (
bapen.org.uk) 5 Ibid 6 Cook, T. M. & Lennane, S. Occupational COVID-19 risk for anaesthesia and intensive care staff – low- risk specialties in a high-risk setting. Anaesthesia (2020) doi:
https://doi.org/10.1111/anae.15358.
7 Jones, R. M. Relative contributions of transmission routes for COVID-19 among healthcare personnel providing patient care. J. Occup.Environ. Hyg. 0, 1–8 (2020)
8 Health and Safety Executive. Rapid Evidence Review. Part one: Equivalence of N95 and FFP2 masks Research: Review of personal protective equipment (disposable respirators, aprons and gowns, eye protection) provided in health care settings to manage risk during the coronavirus (COVID-19) pandemic, HSE news
9 Ibid 10 Ibid
AUGUST 2021
Most effective Elimination
Substitution Engineering Controls
Administrative Controls
PPE
Physically remove the hazard
Replace the hazard
Isolate people from the hazard
Change the way people work
Protect the worker with Personal Protection Equipment
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