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Medical Skills: PPE-Removing gloves-Donning and removing a gown-Types of isolation
Isolation ProceduresIsolation precautions create a
barrier between germs and people & decrease transmission
Check for isolation signs before entering a room
There are standard and transmission based precautions
Standard PrecautionsWhen close to or handling blood,
body fluids, tissues, or mucous membranes use one or more forms of PPE
PPE (personal protective equipment)
Gloves (hand contact w/ body fluids)
Mask, goggles (splash risk or spray risk)
Apron, gown, shoe covers (anticipate clothing contact with body fluids)
Transmission Based PrecautionsMost transmission based
precautions are done in addition to standard precautions
Contact precautions- for germs spread by touching
Ex/severe intestinal diseases; Norovirus, and C. difficile
Gown and glove
Droplet PrecautionsTalking or sneezing patients can
spread disease 3 feet.Ex/ Influenza, Pertussis
(whooping cough), mumpsWear surgical mask
Airborne PrecautionsPatients in negative pressure
rooms (where air is gently sucked out, not allowed to enter hallway)
Ex/measles, TB (tuberculosis), chickenpox
Wear well-fitted respirator mask
Donning Non-sterilized gloveWash handsDon gloves
Removing Gloves
ONLY GLOVE CAN TOUCH GLOVEGrasp with one hand just below cuffPull glove down over hand so that it is
inside outHold removed glove with gloved handReach inside remaining glove with 1st 2
fingers of ungloved hand (touch inside only)
Pull glove down over hand and other glove
Discard and wash hands
Donning and Removing a GownFollow along with instructional
video, then consult your skills check list.
https://www.youtube.com/watch?v=_IYrqiQjvyQ
How to Don a Gown
• Select appropriate type and size• Opening is in the back
PPE Use in Healthcare Settings
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
PPE Use in Healthcare Settings
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
PPE Use in Healthcare Settings
How to Don Gloves
PPE Use in Healthcare Settings
• Don gloves last• Select correct type and size• Insert hands into gloves• Extend gloves over isolation
gown cuffs
Sequence* for Donning PPE• Gown first• Mask or respirator• Goggles or face shield• Gloves
*Combination of PPE will affect sequence – be practical
PPE Use in Healthcare Settings
How to Safely Use PPE• Keep gloved hands away from
face• Avoid touching or adjusting other
PPE• Remove gloves if they become
torn; perform hand hygiene before donning new gloves
• Limit surfaces and items touched
PPE Use in Healthcare Settings
“Contaminated” and “Clean” Areas of 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
PPE Use in Healthcare Settings
Sequence for Removing PPE
• Gloves• Face shield or goggles• Gown• Mask or respirator
PPE Use in Healthcare Settings
Do’s 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
PPE Use in Healthcare Settings
What Type of PPE Would You Wear?
1. Giving a bed bath?2. Suctioning oral
secretions?3. Transporting a
patient in a wheel chair?
4. Responding to an emergency where blood is spurting?
1. Drawing blood from a vein?
2. Cleaning an incontinent patient with diarrhea?
3. Irrigating a wound?4. Taking vital signs?
PPE Use in Healthcare Settings
What Type of PPE Would You Wear?• Giving a bed bath?
• Generally none
• Suctioning oral secretions?
• Gloves and mask/goggles or a face shield – sometimes gown
• Transporting a patient in a wheel chair?
• Generally none required
• Responding to an emergency where blood is spurting?
• Gloves, fluid-resistant gown, mask/goggles or a face shield
• Drawing blood from a vein?
• Gloves
• Cleaning an incontinent patient with diarrhea?
• Gloves w/wo gown
• Irrigating a wound?• Gloves, gown,
mask/goggles or a face shield
• Taking vital signs?– Generally none
PPE Use in Healthcare Settings