Evidence regarding the extended use and decontamination of PPE continues to evolve. Please visit the CDC and FDA websites for their latest recommendations.
Personal protective equipment (PPE) is a regular part of being a direct care provider and important for protecting yourself and your patients. With concerns about availability, it is necessary to understand current recommendations and safe techniques for donning and doffing PPE.
How does the virus spread?
Information continues to emerge daily as more research is completed regarding COVID-19 and the availability and manufacturing of PPE evolve. It is essential to continue to monitor information from credible governmental organizations such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and The Joint Commission. CDC recommendations released on March 31, 2020, offer suggestions to decrease the possibility of transmission in your facility, prepare for patient isolation and protect staff.
Based on our current understanding, the risk for transmission is greatest during close person-to-person contact when infected individuals produce respiratory droplets by coughing, sneezing or talking. Asymptomatic individuals are still able to spread the virus. Since it is unlikely transmission can occur over long distances, social distancing guidelines have been suggested to limit virus spread.
How can you protect yourself?
With thoughtful consideration, you can help your organization plan for the care of patients during the COVID-19 crisis. The American Nurses Association has developed a free webinar (requires registration) that provides great information and insight into planning to protect you and your staff.
Most crucial is hand hygiene before and after all patient contact, during contact with potentially infectious material or surfaces, and before donning and doffing PPE. The CDC has published a PDF with preferred and acceptable alternative PPE for healthcare personnel related to COVID-19. Precautions must be taken when performing aerosol-generating procedures such as those likely to induce coughing.
What are the best practices for using PPE?
In addition to using the correct PPE for confirmed or suspected COVID-19, it is equally important to follow correct procedures for donning and doffing PPE. Based on CDC guidance, the donning procedure should include the followng:
1Gather appropriate PPE - ensure the appropriate size of equipment before beginning
2Perform hand hygiene using hand sanitizer
3Don isolation gown - ensure ties are secure
4Don respirator/face mask - ensure appropriate fit, particularly for those with facial hair
5Put on face shield/goggles - note that face shields provide full face protection
6Perform hand hygiene again prior to donning gloves - ensure gloves go on top of gown cuff
Doffing PPE is equally important, as transmission risk is still present.
1While in the patient’s room, remove gloves without contaminating hands. Make sure the glove is turned inside out as you remove it.
2Remove gown - Untie/unsnap ties, break ties if applicable. Remove by grabbing one shoulder at a time to remove each arm, continue to pull gown down and away from the body. Roll gown as it is removed and place in the proper receptacle. You may now exit the room.
3Upon exit, perform hand hygiene - via handwashing or hand sanitizer
4Remove face shield/goggles - use strap or sides, do not contact the front of them
5Remove and properly handle respirator/face mask - do not contact the front, and dispose or decontaminate as appropriate
6Repeat hand hygiene again
For additional infographics please see:
- Protecting Those Fighting the Coronavirus
- Use Personal Protective Equipment (PPE) When Caring for Patients With Confirmed or Suspected COVID-19 PPE Sequence From CDC
While this information presents you with one procedure for donning and doffing PPE, it is crucial that you follow your organization’s policies and procedures regarding PPE. Most importantly, be sure to perform hand hygiene.
How could you help educate others about the appropriate use of PPE?
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