3. STAY SAFE, SAVE LIVES
• The best way for health care workers to prevent infection with SARS-CoV-2 is through training and demonstrated competency in
puttingonandremoving, alsoknownasdonninganddoffing,personalprotectiveequipment(PPE).
• Person-to-persontransmissionofCOVID-19occurs mainlythrough
• respiratorydropletsreleased when aninfectedpersoncoughs, talks,orsneezes,and
• throughcontactwithcontaminatedsurfaces
• followedbytouchingone’seyes,nose, ormouth
4. INFECTION PREVENTION AND CONTROL
• Standard infection control precautions include the basic measuressuch as
• handhygiene,
• respiratoryhygiene,
• appropriateenvironmentalcleaning,
• properwastemanagementthatshould beusedbyallstaffatall timesforallpatients.
• For patients knownor suspectedto be infected with SARS-CoV-2,additional measuresneedto be implemented.Theseare
• Contact precautions
• Dropletprecautions
• Airborneprecautions (for aerosolgeneratingprocedures)
5. HAND HYGIENE - REVIEW
• Hand Wash/ Hand Rub -Duration
• Materials – Soap and Water; Alcohol based hand rub
• 5moments of Hand Hygiene
• Steps of Hand Hygieneand Drying- VIDEO
10. Respirator
• If disposable N95 respirators are worn, they must be certified by the National Institute for Occupational Safety and Health
(NIOSH) andfit-testedbyoccupationalhealthofficials.
• Therespiratorshould beusedalong withafull faceshieldthatprotectsthefaceandneck.
• Alternatively,aNIOSH-certified,
• poweredair-purifyingrespirator(PAPR) canbeused.
12. How to take off gloves and mask?
Remove gloves inside out, NEJM Remove the respirator using strap, NEJM
13. Waste Management
• Watersealed containerclearlylabelled biomedicalhazard
• 70% ethyl alcohol can be used to disinfect
• The floor should be cleaned with 0.5% chlorine solution or 0.5% sodium hypochlorite solution
(5000 parts per million, or 1-part household bleach with 5% sodium hypochlorite to 9 parts
water) or equivalent disinfectant
• at least every 6-8 hours in noncritical areas
• and every 3-4 hours in critical areas.
14. When PPE is properly worn, removed, and discarded, it is effective in
protecting both the person who wears it and those with whom that person
comes into contact.
15. References:
• https://www.nejm.org/doi/full/10.1056/NEJMvcm2014809?query=featured_homeHinkin J, Gammon J, Cutter J. Review of personal
protection equipment used in practice. Br J Community Nurs. 2008;13:14-9.
• https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
• https://www.who.int/csr/resources/publications/ppe_en.pdf?ua=1
• https://heoc.mohp.gov.np/update-on-novel-corona-virus-covid-19/
• https://nmc.org.np/guidelines-for-use-of-personal-protective-equipment-in-relation-to-covid-19
• https://www.who.int/csr/resources/publications/putontakeoffPPE/en/
• https://www.who.int/publications-detail/water-sanitation-hygiene-and-waste-management-for-covid-19
Editor's Notes
WHO’s “my 5 moments of hand-hygiene” approach.
o Before touching the patient
o Before clean / aseptic procedures
o After body fluid exposure risk
o After touching the patient
o After touching the patient’s surroundings
Begin by covering the respirator with your hands
Inhaling deeply and quickly several times
The respirator should collapse slightly against your face when
you inhale.
Next, place your hands around the edges of the respirator and exhale to determine whether there are any air leaks
If the respirator fails to collapse or if air leaks from the sides, remold the nasal strip and adjust the positioning of the respirator on your face.
If you are still unable to obtain a complete seal, consider using a PAPR.