1.4 Personal Protective Equipment

undefinedBefore undertaking any care task or procedure staff should assess any likely exposure to blood and/or body fluids and ensure PPE is worn that provides adequate protection against the risks associated with the procedure or task being undertaken.

All PPE should be:

Reusable PPE items, e.g. non-disposable goggles/face shields/visors must have a decontamination schedule with responsibility assigned.

Further information on best practice for PPE use for SICPs can be found in Appendix 16.

Gloves must:

Double gloving is only recommended during some Exposure Prone Procedures (EPPs) e.g. orthopaedic and gynaecological operations or when attending major trauma incidents and when caring for a patient with a suspected or known High Consequence Infectious disease.  Double gloving is not necessary at any other time.

For appropriate glove use and selection see Appendix 5.

Further information can be found in the Gloves literature review.

Aprons must be:

Full body gowns/Fluid repellent coveralls must be:

The choice of apron or gown is based on a risk assessment and anticipated level of body fluid exposure. Routine sessional use of gowns/aprons is not permitted.

Sterile surgical gowns must be:

Reusable gowns must:

If hand hygiene with soap and water is required, this should not be performed whilst wearing an apron/gown in line with a risk of apron/gown contamination; hand hygiene using ABHR is acceptable.

Further information can be found in the Aprons/Gowns literature review.

Eye/face protection must:

Regular corrective spectacles and safety spectacles are not considered eye protection.

Further information can be found in the eye/face protection literature review.

Fluid Resistant Type IIR surgical face masks must be:

Transparent face masks

Transparent face masks may be used to aide communication with patients in some settings

Transparent face masks must;

Further information can be found in:

During the ongoing COVID-19 pandemic please also refer to the Scottish Government Extended Use of Facemask Guidance. The extended use of facemask guidance is not considered an element of SICPs but an additional mitigation measure applied in response to the ongoing COVID-19 pandemic response.

Footwear must be:

Further information can be found in the footwear literature review.

Headwear must be:

Further information can be found in the headwear literature review

For the recommended method of putting on and removing PPE see video below and Appendix 6.

COVID-19 - the correct order for donning, doffing and disposal of PPE for HCWs in a primary care setting from NHS National Services Scotland on Vimeo.

 

Sessional use of PPE

Typically, sessional use of any PPE is not permitted within health and care settings at any time as it may be associated with transmission of infection within health and care settings. 

Due to the much wider and frequent use of FRSMs eye/face protection (where required) by HCWs during the ongoing COVID-19 pandemic and during periods of increased respiratory activity in health and care settings both as part of service user direct care delivery and extended use of facemasks guidance, sessional use of FRSMs and eye/face protection is permitted at this time.

This means that FRSMs and eye/face protection (where required) can be used moving between service users and for a period of time where a HCW is undertaking duties in an environment where there is exposure to patients with suspected or confirmed respiratory infection.  A session ends when the healthcare worker leaves the clinical setting or exposure environment.  When using FRSMs and eye/face protection sessionally it is important to note the following;

The above measures in conjunction with safe donning and doffing of PPE ensure the safety of the HCW and the service user.

No other PPE is permitted to be worn sessionally moving between service users or care tasks.  This includes gloves, aprons and gowns.

PPE for Visitors

PPE may be offered to visitors to protect them from acquiring a transmissible infection.  If a visitor declines to wear PPE when it is offered then this should be respected and the visit must not be refused.  PPE use by visitors can not be enforced and there is no expectation that staff monitor PPE use amongst visitors. Below is the PPE which should be worn where it is appropriate to do so and when the visitor chooses to do so.

Visitors do not routinely require PPE unless they are providing direct care to the individual they are visiting.  In line with extended use of face mask guidance, visitors are strongly recommended to continue to wear a face covering when visiting a healthcare setting.  Should they arrive without one, they can be provided with a FRSM. 

The table below provides a guide to PPE for use by visitors if delivering direct care. 

IPC Precaution

Gloves

Apron

Face covering/mask

Eye/Face Protection

Standard Infection Control Precautions (SICPs)

Not required*1

Not required*2

Where splash/spray to nose/mouth is anticipated during direct care

Encourage the use of face covering (or provide with Type IIR FRSM if visitor arrives without a face covering) in line with Extended use of face masks guidance

Not required*3

Transmission Based Precautions (TBPs)

Not required*1

Not required*2

If within 2 metres of service user with suspected or known respiratory infection

Encourage the use of face covering (or provide with Type IIR FRSM if visitor arrives without a face covering) in line with Extended use of face masks guidance

If within 2 metres of service user with suspected or known respiratory infection

*1 unless providing direct care which may expose the visitor to blood and/or body fluids i.e. toileting.

*2 unless providing care resulting in direct contact with the service user, their environment or blood and/or body fluid exposure i.e. toileting, bed bath.

*3 Unless providing direct care and splashing/spraying is anticipated