Canberra Hospital and Health Services Standard Operating Procedure Personal Protective Equipment



Download 167.17 Kb.
Page1/3
Date conversion20.01.2018
Size167.17 Kb.
  1   2   3

CHHS12/251


Canberra Hospital and Health Services

Standard Operating Procedure

Personal Protective Equipment

Purpose

To utilise personal protective equipment (PPE) to prevent the transmission of infectious agents to the hands, skin and clothing of healthcare workers as well as the exposure of workers to dangerous chemicals.




Scope

All Health Directorate staff at risk of exposure to blood, other body fluids or chemicals and where there is a risk of contamination with blood, body substances, secretions or excretions (except sweat).

Staff should refer to Area Specific Manuals for SOPs relating to PPE and the handling of chemicals and cytotoxics.


Procedure

PPE is designed and issued for a particular purpose in a protected environment and should not be worn outside that area.



Protective clothing provided for staff in areas where there is high risk of contamination (e.g. operating suite/room) must be removed before leaving the area.

Gowns and aprons

  • Clinical and laboratory coats or jackets worn over personal clothing for comfort and/or purposes of identity are not considered to be PPE

  • Aprons/gowns are routinely used upon entering the room of a patient requiring contact precautions

  • Gowns and aprons must be changed between patients

  • Aprons and gowns should be removed in a manner that prevents contamination of clothing or skin. The outer, ‘contaminated’, side of the gown is turned inward and rolled into a bundle, and then discarded into a designated container for waste or linen to contain contamination.



Table 1 Characteristics of aprons/gowns

Plastic apron

  • Impervious /fluid resistant

  • Single-use, for one procedure or episode of patient care

  • Disposable

  • Worn when there is a risk that clothing may become exposed to blood or body substances (usually from the environment) during low-risk procedures and where there is low risk of contamination to the healthcare worker’s arms

  • Worn during contact precautions when contact with the patient or the patient environment is likely

Gown

  • Single-use*

  • Disposable

  • Worn to protect skin and prevent soiling of clothing during procedures and/or patient-care activities that are likely to generate splashing or sprays of blood or body substances




Full body gown

  • Fluid resistant

  • Single-use*

  • Long sleeved

  • Worn when there is a risk of contact of the healthcare worker’s skin with a patient’s broken skin, extensive skin to skin contact (e.g. lifting a patient with scabies or non-intact skin), or a risk of contact with blood and body substances which are not contained (e.g. vomiting, uncontrolled faecal matter)

  • Worn when there is the possibility of extensive splashing of blood and body substances

  • Worn when there is a risk of exposure to large amounts of body substances eg in some operative procedure

Sterile gown*

  • Pre-packaged

  • Used for procedures requiring an aseptic field

*Some gown types can be re-used. Reusable gowns need to be laundered or reprocessed according to AS/NZS4146—2000 Laundry Practice

Face and Eye Protection

Face and eye protection reduces the risk of exposure of healthcare workers to splashes or sprays of blood and body substances and is an important part of standard precautions. Procedures that generate splashes or sprays of blood, body substances, secretions or excretions require either a face shield or a mask worn with protective eyewear.

Removal of a face shield, protective eyewear and surgical mask can be performed safely after gloves have been removed and hand hygiene performed. The ties, earpieces and/or headband used to secure the equipment to the head are considered ‘clean’ and therefore safe to touch with bare hands. The front of a mask, protective eyewear or face shield is considered contaminated.

Reusable face shields and protective eyewear should be cleaned according to the manufacturer’s instructions, generally with detergent solution, and be completely dry before being stored. If they are to be disinfected, they should be disinfected using either a TGA-registered instrument grade disinfectant - low level, or by heat as per AS/NZS 4187:2003.


NOTE: Prescription eyewear is not considered to give sufficient protection to the eyes in an environment where splashing, splattering, spraying or spilling of blood or body substances or chemicals is likely. Safety glasses or face shields designed to wear over prescription glasses are available.

Table 2 Use of face and eye protection as part of standard precautions

Type of care

Examples

Face and eye protection required

Routine care

General examination (e.g. medical, physiotherapy, nursing)
Routine observations

Not required unless caring for a patient on droplet precautions (surgical mask) or airborne precautions (P2 respirator)

Procedures that generate splashes or sprays

Dental procedures
Nasopharyngeal aspiration
Emptying wound or catheter bag

Protective eyewear/full-length face shield
Surgical mask

Procedures involving the respiratory tract (including the mouth)

Intubation
Nasopharyngeal suction

Protective eyewear
P2 respirator


Surgical masks

Surgical masks are loose fitting, single-use items that cover the nose and mouth. They are used as part of standard precautions to keep splashes or sprays from reaching the mouth and nose of the person wearing them. Surgical masks can be placed on coughing patients to limit potential dissemination of infectious respiratory secretions from the patient to others.



Considerations when using a surgical mask or respirator include:

  • if the respirator becomes damaged, soiled, or breathing becomes difficult leave the contaminated area and replace the respirator

  • masks should never be reapplied after they have been removed

  • masks should not be left dangling around the neck

  • touching the front of the mask while wearing it should be avoided and

  • hand hygiene should be performed upon touching or discarding a used mask.

NB: Children should wear a specifically designed child mask and their oxygen saturation should be monitored.
Table 3 Properties of different types of mask

Properties

Surgical masks

P2/N95 respirator (see Section B2.4.3)

Other names

Single-use face mask, medical mask, patient-care mask, general purpose mask

P2/N95 respirator, respiratory protection device, particulate respirator

Characteristics

  • Raised dome or duckbill

  • 4–5 layers (outer polypropylene, central layers electrets [charged polypropylene])

  • Filtration through mechanical impaction and electrostatic capture

Sealing

  • Ties at crown and bottom of head

  • Ties at crown and bottom of head, pliable metal nose bridge

  • Fit checking required

Australian standards

  • AS4381:2002

  • AS1715:2009

Intended use

  • Procedures that generate splashes or sprays of large droplets of blood, body substances, secretions and excretions

  • Procedures requiring a surgical aseptic technique (to protect patients from exposure to infectious agents carried in a healthcare worker’s mouth or nose)

  • Routine care of patients on droplet precautions

  • Routine care of patients on airborne precautions

  • High-risk procedures such as bronchoscopy when the patient’s infectious status is unknown

  • Procedures that involve aerosolisation of particles that may contain specific known pathogens




Notes




  • Care must be taken when placing respirators on patients and must suit clinical need (i.e. if the patient has chronic obstructive airways disease [COAD] or is in respiratory distress, the respirator will exacerbate symptoms).


Gloves

Gloves can protect both patients and healthcare workers from exposure to infectious agents that may be carried on hands. As part of standard precautions, they are used to prevent contamination of healthcare workers’ hands when:



  • anticipating direct contact with blood or body substances, mucous membranes, non-intact skin and other potentially infectious material; and

  • handling or touching visibly or potentially contaminated patient-care equipment and environmental surfaces.
  1   2   3


The database is protected by copyright ©dentisty.org 2016
send message

    Main page