Donning | |
---|---|
1. | Hand hygiene |
2. | Gown / coverall |
3. | Facemask |
4. | Eye protection / Face shield (face shield recommended if high risk of splashes and sprays of blood and body fluids e.g. trauma, haemorrhage) |
5. | Gloves |
Doffing | |
---|---|
1. | Gloves |
2. | Hand hygiene |
3. | Gown / coverall |
4. | Hand hygiene |
5. | Eye protection / Face shield |
6. | Hand hygiene |
7. | Facemask |
8. | Hand hygiene |
1. Perform hand hygiene (hand sanitiser in field settings OR soap and water with hand sanitiser in clinic or hospital settings)
2. Select appropriate size gloves for wearer. Check package for integrity and use by date. If in doubt discard and get a new pair.
Non-clinical PPE (e.g. high-visibility jackets, helmets etc…) are not included in this document. Please refer to relevant Workplace Instructions and Safety information.
PPE includes:
Gloves are worn as a barrier to protect the hands from contamination or to prevent the transfer of microorganisms already on the hands. They are single use items to be worn when performing invasive procedures, when in contact with non-intact skin or mucous membranes, and any activity where there is high risk of exposure to blood and body fluids, including cleaning of equipment and vehicles.
Gloves do not need to be routinely worn for all patient contact when the risk of exposure to blood and body fluids is minimal.
Prolonged glove use can lead to lack of hand hygiene and increase risk of contact dermatitis.
Hand hygiene must always be performed prior to donning gloves and immediately after removal (Refer to CPG 12.2. Hand Hygiene).
Surgical masks should be worn by the patient on droplet and airborne precautions to contain respiratory secretions of the wearer.
P2/N95 respirator provides protection from diseases transmitted through the droplet and airborne route. P2/N95 respirators must be fit checked before patient contact.
Fitting a flat style respirator
Fitting a cup style respirator
Indications for use of a P2/N95 respirator:
Indications for removal of P2/N95 respirator:
Protective eyewear protects the conjunctiva from exposure to blood, body fluids, and secretions propelled into the air by coughing or sneezing.
Reusable protective eyewear should be cleaned and disinfected following use.
Disposable full face shields and are recommended when there is a high risk of splashes and sprays of blood and body fluids (e.g. trauma, haemorrhage) and are to be discarded after use.
Prescription eyewear is not considered protective as it allows contaminants to travel between the lens and the face.
Indications for the use of protective eyewear:
Disposable fluid-resistant coveralls or gowns are used to prevent skin and uniforms being contaminated with blood/ bodily fluids. The need for a gown/coverall will depend on the degree of risk, including the anticipated degree of contact with infectious material and the potential for blood and body substances to penetrate through to clothes or skin.
Indications for the use of coveralls/gowns:
The following items are not routinely recommended as part of contact, droplet or airborne precautions, however for specific situations may be introduced as a SJWA directive.
Head coverings
Boot covers
Use of boots covers is not recommended unless gross contamination is anticipated, as:
Powered air-purifying respirators (PAPRs) are an alternative to P2/N95 respirators in selected circumstances:
To reduce the risk of transmission of infectious agents, PPE must be used appropriately. Ideally PPE should be applied before patient contact. In the pre-hospital setting it is not always possible to identify times when PPE is required and this will need to be assessed on the individual basis.
If it is suspected or confirmed the patient has an infection that can be spread by the droplet or airborne route (such as influenza, measles) place a surgical facemask on the patient to help minimise the spread of respiratory droplets. However not all patients will be able to tolerate this. In these cases, encourage the patient to use a tissue to cover their nose and mouth when coughing/sneezing.
Perform hand hygiene
Gown/Coveralls
Gown:
Coveralls:
P2/N95 respirator
Eye protection/face shield
Gloves
Gloves
Perform hand hygiene
Gown/Coveralls
Perform hand hygiene
Protective Eyewear/face shieldPerform hand hygiene
P2/N95 respirator
Perform Hand hygiene
References
Government of Western Australia Department of Health. (2013). IC: 0142/13 Fit testing and fit checking of particulate filter respirators (masks) in Western Australian healthcare facilities. Perth, Australia.
National Health & Medical Research Council and the Australian Commission on Safety and Quality in Healthcare. (2010). Australian guidelines for the prevention and control of infection in healthcare. Canberra, Australia: Commonwealth of Australia.
Ontario Emergency Services Branch Ministry of Health and Long-Term Care. (2007). Infection Prevention and Control Best Practices Manual for Land Ambulance Paramedics.
South Western Ambulance Service NHS Trust. (2010). Guidance and procedures for infection prevention and control. Managing healthcare associated infection and control of serious communicable diseases. United Kingdom: South Western Ambulance Service NHS Trust.
Standards Australia/Standards New Zealand. AS/NZS 4011:1997/Amdt 1:1998. Single-use examination gloves - Specification. Sydney, Australia: Standards Australia International Limited.
Standards Australia. AS 4381:2002. Single-use face masks for use in healthcare. Sydney, Australia: Standards Australia International Limited.
Standards Australia/Standards New Zealand. AS/NZS 1716:2003/Amdt 1:2005. Respiratory protective devices. Sydney, Australia: Standards Australia International Limited.
Standards Australia/Standards New Zealand. AS/NZS 1715:1994. Selection, use and maintenance of respiratory protective devices. Sydney, Australia: Standards Australia International Limited.
Standards Australia/Standards New Zealand. AS/NZS 1336:1997/Amdt 1:1997. Recommended practices for occupational eye protection. Sydney, Australia: Standards Australia International Limited.
Standards Australia/Standards New Zealand. AS/NZS 1337:1992/Amdt 1:1994/Amdt 2:1997. Eye protectors for industrial application. Sydney, Australia: Standards Australia International Limited.
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