Personal protective equipment
Personal protective equipment – known as ‘PPE’ – is used to protect health care workers while performing specific tasks that might involve them coming into contact with blood or body fluids that may contain some infectious agents (germs).
It includes many of the items often associated with health care by the public – gowns, gloves and masks. These items will be for single-use only – that is, you MUST use them once and then discard them – while others are retained, cleaned and reused.
This is crucial, because PPE will only protect you and others from harm if you are able to put it on, use it, remove it and dispose of it in the correct manner. Getting it wrong at any of these stages can lead to germs being passed on. We’ll look at the various waste streams into which PPE and other items are placed in the next section.
But the first question you need to be able to answer is – when do I need to wear PPE?
The short answer is that your employer will have procedures, policies and protocols in place that will tell you. Some of these are national, so all health care settings will be working to them, while others are local and are designed to meet particular challenges in your workplace.
We look at protocols in the quality section, but for now, if you are unsure about whether you need to wear PPE or not, ask a registered member of staff to go through the local procedures, policies and protocols with you.
What is personal protective equipment (PPE)?
The following are common items of PPE that you’ll find in most health care settings and care homes:
- disposable gloves
- disposable plastic aprons.
There are other items of PPE that you may be asked to use on occasion in your workplace – you will be advised about this by your manager or supervisor.
Disposable gloves should only be worn if you’re performing or assisting in a procedure that involves a risk of contact with body fluids, broken skin, dirty instruments and harmful substances such as chemicals and disinfectants. Gloves should not be routinely used or put on ‘just in case’. This is dangerous for the patient/client as you will not be able to wash your hands when you are wearing gloves. Gloves need to be used in specific circumstances only. This includes procedures that involve:
- a risk of being splashed by body fluids (blood, saliva, sputum, vomit, urine or faeces, for instance)
- contact with the patient’s/client’s eyes, nose, ears, lips, mouth or genital area, or any instruments that have been in contact with these
- contact with an open wound or cut
- handling potentially harmful substances, such as disinfectants.
Note that disposable gloves are NOT necessary for many parts of routine day-to-day care, like helping a patient/client to wash and dress or bed-making.
The gloves should:
- fit you comfortably (not be too tight or too loose)
- be changed between patients/clients and between different tasks with the same patient/client
- never be washed or reused.
When you’ve finished the procedure, you should take the gloves off, avoiding touching the outer surfaces (which are likely to be contaminated with germs), and dispose of them in the correct waste-disposal system. You must then perform hand hygiene. You can read the RCN guide on glove use and the prevention of contact dermatitis (a skin condition that can arise if gloves are used incorrectly over time).
Some gloves have a substance called ‘latex’ that can cause serious allergies. If you know you have an allergy to latex, you must tell your employer so that alternative gloves can be supplied. You will also be told when particular patient/clients have latex allergies and mustn’t have contact with latex gloves. Some nursing staff experience sore hands as a result of their job, usually caused by a mixture of things such as wet work (bathing, washing patients), using wipes and alcohol hand gel, wearing gloves and not drying their hands properly. If you have sore hands you should tell your manager and report it to you occupational health department or lead.
These aren’t needed to carry out many normal aspects of day-to-day care with patients/clients, such as helping them to go for short walks, but you will need one when you are:
- performing or assisting in a procedure that might involve splashing of body fluids
- performing or helping the patient/client with personal hygiene tasks
- carrying out cleaning and tidying tasks in the patient’s/client’s living space, such as bed-making.
You must always perform hand hygiene before putting a disposable gown on and after taking it off and placing it in the correct clinical waste bin.
Note that different organisations have different-coloured aprons for different tasks – you should always check your workplace’s local policy.
Applying, removing and disposing of PPE
As we’ve mentioned, PPE will only protect you and others if you know how to put it on and take it off correctly and dispose of it safely. The following gives you some general guidance, but specific PPE items vary. Your employer and registered staff in your area will be able to advise you.
- select correct glove size and type.
- perform hand hygiene.
- pull to cover wrists.
- grasp the outside of the glove with the opposite gloved hand and peel off.
- hold the removed glove in the gloved hand.
- slot your finger under the lip of the remaining glove and peel it off, taking care not to touch the contaminated outer surface.
- dispose of the gloves in the clinical waste bin.
- perform hand hygiene.
Aprons must always be changed after you finish care activities with each person.
Pull the apron over your head and fasten at the back of your waist.
- unfasten (or break) the ties.
- pull the apron away from your neck and shoulders, lifting it over your head and taking care to touch the inside only, not the contaminated outer side.
- fold or roll the apron into a bundle with the inner side outermost.
- dispose of the apron in the clinical waste bin.
- perform hand hygiene.