Infection Control Guidelines for appropriate use of personal protective equipment Barrier technique personal protective equipment Dr. Nahla Abdel Kader.MD, PhD. Infection Control Consultant, MOH Infection Control Surveyor, CBAHI Infection Control Director,KKH. 

2. Barrier Technique
Personal Protective Equipments
(PPE) (IC- P &P 007)

3. End in Mind
1. Introduction to Personal Protective
Equipment (PPE)
2. Understanding the importance of
(PPE)
3. Understanding when to use (PPE)
4. Understanding how to don and
remove (PPE)

4. Definition
“Specialized clothing or
equipment worn by an
employee for protection
against infectious materials”
(OSHA)

5. Hierarchy of Safety and Health Controls
Training and
administrative controls
Engineering controls
Work practice controls
Personal protective
equipment (PPE)
(CDC)

6. Factors Influencing PPE Selection
Splash/spray versus
touch
Category of isolation
exposure precautions
Type of
anticipated
Durability and
appropriateness for
the task
Fit

7. When to Use PPE
Standard
Precautions
Transmissionbased
Precautions

8. When Not to Use PPE
•
•
•
•
Wearing in public areas
Failure to discard after use
Wearing too many
Failure to remove gloves after each task

9. Types of PPE used in Healthcare
Gloves
Masks
Head Covers
Shoes Covers
Gowns
Face shields
Eye protection

10. Gloves
•
Purpose – patient care, environmental
services, other
•
•
•
•
•
Glove material – vinyl, latex, or nitrile
Glove fit
Sterile or non-sterile
One or two pair
Single use or reusable

11. Dos and Don’ts of Glove Use
●
●
Work from “clean to dirty”
Limit opportunities for “touch contamination” - protect yourself,
others, and the environment
 Don’t touch your face or adjust PPE with contaminated gloves
 Don’t touch environmental surfaces except as necessary
during patient care
●




Change gloves
During use if torn and when heavily soiled (even during use on
the same patient)
After use on each patient
Discard in appropriate receptacle
Never wash or reuse disposable gloves

12. Gowns or Aprons
• Purpose of use
• Material –
 Natural or man-made
 Reusable or disposable
 Resistance to fluid penetration
• Clean or sterile

13. Face Protection
• Masks – protect nose and mouth
 Should fully cover nose and mouth and prevent fluid penetration
• Eye Goggle – protect eyes
 Should fit snuggly over and around eyes
 Personal glasses not a substitute for goggles
 Antifog feature improves clarity
● Face shields – protect face, nose, mouth, and
eyes
 Should cover forehead, extend below chin and wrap around sides of
face

14. Respiratory Protection
• Purpose – protect from inhalation of
infectious aerosols (example:
Mycobacterium tuberculosis)
• PPE types for respiratory protection
 Particulate respirators
 Half- or full-face elastomeric respirators
 Powered air purifying respirators (PAPR)

15. Sequence for Donning PPE
• Gown first
• Mask or respirator
• Eye protection or face shield
• Gloves

16. How to Don a Gown
• Select appropriate type and
•
•
•
size
Opening should be in the back
Secure at neck and waist
If gown is too small, use two
gowns
 Gown #1 ties in front
 Gown #2 ties in back

17. How to Don a Mask
• Place over nose, mouth and
•
•
•
chin
Fit flexible nose piece over
nose bridge
Secure on head with ties or
elastic
Adjust to fit

18. How to Don a Particulate Respirator
•
•
•
•
•
•
Select a fit tested respirator
Place over nose, mouth and chin
Fit flexible nose piece over nose bridge
Secure on head with elastic
Adjust to fit
Perform a fit check –
 Inhale – respirator should collapse
 Exhale – check for leakage around face

19. How to Done Eye and Face Protection
• Position eye protection over
•
•
eyes and secure to the head
using the ear pieces or
headband
Position face shield over
face and secure on brow
with headband
Adjust to fit comfortably
١٩

20. How to Don Gloves
• Don gloves last
• Select correct type and size
• Insert hands into gloves
• Extend gloves over
isolation gown cuffs

21. How to Safely Remove PPE
• Contaminated – outside front
 Areas of PPE that have or are likely to have been in contact with body
sites, materials, or environmental surfaces where the infectious
organism may reside
• Clean – inside, outside back, ties on head
and back
 Areas of PPE that are not likely to have been in contact with the
infectious organism

22. Sequence for Removing PPE
Remove the most contaminated items first
1. Remove gloves
2. Remove head cover
3. Remove eye protection
4. Remove respirator
5.Remove gown
5. Perform hand hygiene

23. Where to Remove PPE
• At doorway, before leaving patient room or
in anteroom (at least 1 m from the
patient)*
• Remove respirator outside room, after door
has been closed*

24. How to Remove Gloves (Step 1)
• Grasp outside edge near wrist
• Peel away from hand, turning
•
glove inside-out
Hold in opposite gloved hand

25. How to Remove Gloves (Step 2)
• Slide ungloved finger
•
•
under the wrist of the
remaining glove
Peel off from inside,
creating a bag for
both gloves
Discard

26. Remove Goggles or Face Shield
• Grasp ear or head pieces
•
•
with ungloved hands
Lift away from face
Place in designated
receptacle for reprocessing
or disposal

27. Removing Isolation Gown
• Unfasten ties
• Peel gown away from
•
•
•
neck and shoulder
Turn contaminated
outside toward the inside
Fold or roll into a bundle
Discard

28. Removing a Mask
• Untie the bottom tie, then
•
•
the top tie
Remove from face
Discard

29. Removing a Particulate Respirator
• Lift the bottom elastic
over your head first
• Then lift off the top
elastic
• Discard

30. Summary
• The correct order of donning and removing
PPE is key to protecting yourself and
coworkers from contamination.
• Expanded precautions are used to supplement
the standard precautions that should be
practiced on all patients.
• Make it a habit to practice the correct
sequence of PPE donning and removal as
drills to make it second nature.