• Assess risk of transmission of the micro-organism to patient or healthcare worker
• Assess risk of contamination of the healthcare worker’s clothing or skin by the patient's blood or body fluid
• Assess suitability of the personal protective equipment for proposed use
• Follow current guidelines in respect of COVID-19 and any other diseases

When

• Wear disposable gloves for:
• invasive procedures
• performing aseptic non touch technique (ANTT)
• contact with sterile sites, non-intact skin or mucous membranes
• managing surgical wounds
• anticipated contact or exposure to blood, body fluids, secretions and excretions
• handling sharp or contaminated instruments
• application of topical preparations
• contact with cytotoxic agents
• contact with chemicals
• when decontaminating equipment

How

• Put gloves on immediately before required and remove as soon as activity is completed
• Following removal of gloves, decontaminate hands
• Change gloves between care activities for different patients or between different care activities on the same patient
• gloves are single-use items

Choice

• Use non-latex gloves
• Choice of sterile or non-sterile will depend on the intended procedure
• A range of CE-marked gloves of different sizes and suitable for the task available in all clinical areas

Fluid-repellent gowns

• Risk of extensive splashing of blood and body fluids
• e.g. major trauma or during major surgical procedures, or for certain infections
• Wear a full-body fluid-repellent, single-use gown

Plastic aprons

• Wear a disposable plastic apron if:
• clothing or uniform may be exposed to blood, body fluids, secretions and excretions
• caring for patients with certain infections e.g. Clostridium difficile
• Change plastic aprons between patients and between different care activities on the same patient
• aprons are single-use items

• Wear depending on:
• known/suspected infectious status of the patient
• presenting symptoms
• task involved
• risk of splashing to eyes and face

Splash and droplets

Droplets

• Droplets are expelled from the respiratory tract during coughing and sneezing
• The minimum distance for droplet precautions is 2 m
• the minimum not an absolute distance

Airborne transmission

• Coughing, sneezing and aerosol generating procedures generate aerosol particles from respiratory tract
  • can remain in the air for long periods of time
  • be carried over long distances by air currents

Surgical face masks (IIR)

• Provide a barrier to splashes and droplets impacting on the wearer’s nose, mouth and respiratory tract
• Must be fluid resistant to protect against infection
• Do not provide protection against airborne (aerosol) particles

FFP3 (respirator) masks

• Provide respiratory protection from airborne transmitted organisms and during aerosol generating procedures;

Valved or non-valved FFP3 mask?

• When sterility directly over the sterile field is required, wear a non-valved mask (filters expired air)
  • e.g. in theatres/surgical settings or when undertaking a sterile procedure
  • valved are more comfortable for the wearer but do not filter the expired air

Fit testing

• Before using a FFP3/respirator mask, a competent person will fit test to verify the user
  • has a mask suitable for their face shape
  • puts it on with no gaps between the mask and their face for air to pass through unfiltered
  • results are recorded and available
  • informed to only wear the type and make/model of mask fitted
• Undertake fit testing every 2 yr and in the following circumstances:
  • necessary to change to another type, make/model of face piece
  • wearer has lost or gained weight
  • wearer has undergone substantial dental work or developed facial imperfections such as scars, moles around the face seal
  • new facial piercings

Fit check

• Each time a FFP3/respirator mask is worn, the wearer fit checks by:
  • covering the front of the mask with clean hands
  • for a non-valved mask, exhaling sharply
  • for a valved mask, inhaling sharply
  • if airflow is present around the nose, readjust the nosepiece, if air flows around the edges of the mask readjust the headbands
• A successful fit check is when there is no air leaking from the edges of the mask
• If a successful check cannot be achieved, remove, and refit the mask
• If you still cannot obtain a successful fit check, do not enter the work area

Loose fitted powered respirator with hoods/helmets particulate filter

• Loose fitted powered respirator with hoods/helmets are an alternative to tight fitting FFP3 mask e.g. when fit test cannot be achieved
• Use a model available approved by infection prevention and health and safety
• Mask fit testing is not required for air powered respirators
• User requires education on safety and maintenance checks, donning and doffing, filter change, decontamination and safe storage
• Expired air not filtered

Protective eyewear and face shields

• Wear if:
• secretions, excretions or blood may be splashed or sprayed towards the face
• delivery procedures, surgical/invasive procedures, severe trauma or other patient care activities, e.g. suctioning, chest physiotherapy
• resuscitation/intubation and exubation of a patient with suspected/confirmed serious infection e.g. meningitis
• Regular spectacles are not eye protection

• Remove personal protective equipment in the following sequence
• gloves
• apron/gown
• decontaminate hands
• eye protection
• mask/respirator
• decontaminate hands
• Masks are single-use items
• discard in the clinical waste bins