Nurses guide to personal protective equipmentNovember 19, 2014
Working as a nurse can sometimes be hazardous. From common infections, such as influenza to frightening diseases, such as Ebola, nurses treat patients with all types of infectious conditions. It is important to wear the right personal protective equipment to keep yourself from becoming infected and to prevent spreading illness from patient to patient inadvertently. Knowing what type of personal protective equipment to wear in different situations is essential for nurses.
Types of personal protective equipment
Personal protective equipment is specialized equipment or clothing you use to protect yourself and patients from germs. It creates a barrier between the virus, bacteria or fungi and you. PPE includes gloves, gowns, goggles, masks and face shields.
A surgical mask is used to cover your nose and mouth and prevent germs from entering. In other situations, a mask called a respirator may be required. A respirator fits tightly and creates a seal around your nose and mouth, in order to prevent small droplets from entering the body.
Keep in mind that respirators come in different sizes. If you do not wear the correct size, you may not be protecting yourself. Healthcare facilities are required to fit test employees to determine, which size respirator they should use.
Goggles and face shields may be used to prevent body fluids from contact with the mucous membranes of the eyes and may be recommended depending on the procedure you are performing. Gowns, gloves and shoe coverings may also be used to prevent contact with germs.
Choose the right equipment
You will not need to wear all equipment in every situation. Depending on the type of germ or infection, you may need different equipment. For example, in order to prevent certain types of infections, you may need to wear a mask. In other situations, you may only need a gown and gloves.
The type of exposure you expect to have is also an important consideration when selecting equipment. For instance, you may need different equipment if you are drawing blood than you would if you are taking a medical history.
Keep in mind, standard precautions apply to working with all patients regardless of their condition. If you will be handling blood or other body fluids, or will be close to open wounds or mucous membranes, wear gloves, a mask and gown.
Types of precautions
Hospitals and healthcare facilities place patients in different types of precautions based on the organism causing the infection. Hospitals generally have signs on the patient’s door listing what type of precaution or isolation the patient is in. Before entering the room, don the appropriate protective equipment.
The precautions listed below are considered transmission based precautions, which means specific equipment is needed based on the germ or infection the patient has.
Some patients are placed in contact precautions if they have a condition that can be contracted through touching or contact. MRSA and c.difficile are examples of two types of bacteria, which may be spread through contact. If a patient is in contact precautions, you need to wear gloves and a gown.
Droplet precautions are for patients who have an illness, which could be spread through contact with secretions from the mouth, nose and lungs when a patient coughs or sneezes. Usually, the droplets can only travel about three feet. Examples of droplet precaution illnesses include whooping cough and influenza. If you are treating a patient in droplet precautions you need to wear a mask, gown and gloves.
If a patient has an illness caused by a germ that can travel through the air long distances, they are placed in airborne precautions. Patients should also be placed in a special room called a negative pressure room. Negative pressure rooms prevent the air from flowing into the hallways. Tuberculosis and chicken pox are examples of illnesses that would require a patient to be placed in airborne precautions. A gown, gloves and respirator are required if you are treating a patient in airborne precautions.
Isolation precautions are usually intended to keep yourself protected from germs the patient may be carrying, but reverse isolation is different. The purpose is to protect the patient from any germs the staff or visitors are carrying. Patients who have a decreased immune system, usually from chemotherapy, may be placed in reverse isolation. If you have a patient in reverse isolation, you need to wear gloves, a mask and a gown.
Using personal protective equipment correctly
It may seem pretty simple to put a mask and gloves on, but many healthcare workers do not use protective equipment correctly. For example, there is a specific order to don equipment and an order to remove it to prevent contamination. According to the Centers for Disease Control and Prevention, when putting equipment on, start with a gown first, then the mask, goggles and gloves.
Equipment should be removed as soon as you are done caring for the patient. If there is an anteroom, which is a smaller, separate room connected to the patient’s room, remove equipment there. If there is not an anteroom, remove equipment at the door. The CDC recommends removing equipment in the following sequence; gloves, face shield, mask and gown.
Pay special attention when removing equipment to avoid contaminating yourself. In addition, immediately after you remove your equipment, wash your hands. Even if you have been wearing gloves, hand washing is one of the best ways to protect yourself and avoid cross contamination.
If you are unsure what type of protective equipment to use, err on the side of caution. For instance, it does not hurt to wear a mask if you didn’t need one. In fact, if you have a lowered immune system for any reason or are pregnant, a little overkill when it comes to personal protective equipment may be a good idea.
Coming into contact with germs is part of the job for nurses. Understanding what type of equipment to use in which situation can help you stay well.