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Information

Using PPE

What you need !!navigator!!

Gowns gloves goggles masks specially marked laundry bags (and water-soluble laundry bags, if used) plastic trash bags.

An isolation cart may be used when the patient's room has no anteroom. It should include a work area (such as a pull-out shelf), drawers or a cabinet area for holding isolation supplies, and, possibly, a pole on which to hang coats or jackets. A door card announcing that isolation precautions are in effect should also be posted.


Getting ready !!navigator!!

Remove the cover from the isolation cart if necessary and set up the work area. Check the cart or anteroom to ensure that correct and sufficient supplies are in place for the designated isolation category.


How you do it !!navigator!!
  • Wash your hands with an antiseptic cleaner to prevent the growth of microorganisms under gloves.

Putting on PPE
  • Put the gown on and wrap it around the back of your uniform. Tie the strings or fasten the snaps or pressure-sensitive tabs at the neck. Make sure your uniform is completely covered and secure the gown at the waist.
  • Place the mask snugly over your nose and mouth. Secure ear loops around your ears or tie the strings behind your head high enough so the mask won't slip off. If the mask has a metal strip, squeeze it to fit your nose firmly but comfortably. (See Putting on a face mask.) If you wear eyeglasses, tuck the mask under their lower edge.
  • Put on goggles, if necessary.
  • Put on the gloves. Pull the gloves over the cuffs to cover the edges of the gown's sleeves.

Removing PPE
  • Remember that the outside surfaces of your barrier clothes are contaminated.
  • Untie the gown's waist strings with gloves still on.
  • With your gloved left hand, remove the right glove by pulling on the cuff, turning the glove inside out as you pull. Don't touch any skin with the outside of either glove. (See Removing contaminated gloves.) Then remove the left glove by wedging one or two fingers of your right hand inside the glove and pulling it off, turning it inside out as you remove it. Discard the gloves in the trash container.
Mask can be last
  • Untie your mask, holding it only by the strings. Discard the mask in the trash container. If the patient has a disease that's spread by airborne pathogens, you may prefer to remove the mask last.
  • Untie the neck straps of your gown. Grasp the outside of the gown at the back of the shoulders and pull it down over your arms, turning it inside out as you remove it to avoid spreading the pathogens.
  • Holding the gown well away from your uniform, fold it inside out. Discard it in the laundry or trash container as necessary.

Hand hygiene
  • If the sink is inside the patient's room, wash your hands according to the hand hygiene guidelines before leaving the room. Turn off the faucet using a paper towel and discard the towel in the room. Grasp the door handle with a clean paper towel to open it and discard the towel in a trash container inside the room. Close the door from the outside with your bare hand.
  • If the sink is in an anteroom, wash your hands and forearms following the hand hygiene guidelines after leaving the room.
  • A poster illustrating donning PPE is available from the CDC at http://www.cdc.gov/HAI/pdfs/ppe/ppeposter148.pdf or a video, CNA Skill #8 Donning and Doffing PPE, is available from the ACLS Certification Center at http://www.youtube.com/watch?v=urKd0Up_yao.

Practice pointers !!navigator!!
  • Use gowns, gloves, goggles, and masks only once and discard them in the appropriate container before leaving a contaminated area. If your mask is reusable, retain it for further use unless it's damaged or damp. Be aware that PPE loses its effectiveness when wet because moisture permits organisms to seep through the material. Change masks and gowns as soon as moisture is noticeable or according to manufacturer recommendations or facility policy.

Fill 'er up
  • After patient transfer or discharge, return the isolation cart to the appropriate area for cleaning and restocking of supplies. An isolation room and all equipment in it such as intravenous (I.V.) pumps, monitors, and so forth must be thoroughly cleaned and disinfected before use by another patient. Special cleaning agents may be required to eliminate the pathogens and prevent the spread of infection. Refer to policies and procedures at your facility.
  • Restock items at the end of your shift so PPE is readily available for the next shift. (See Documenting isolation precautions.)

Outline