PROTECTIVE

PERSONAL
EQUIPMENT

REGINA STARLA A. DIZON, RN

Infection Prevention and Control Officer
OBJECTIVES
01 WHEN IT IS NECESSARY

02 WHAT KIND IS NECESSARY

03 HOW TO PROPERLY PUT IT ON,

ADJUST, WEAR AND TAKE IT OFF
DEFINITION OF TERMS
INFECTION
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not
normally present within the body. An infection may cause no symptoms and be subclinical, or it may
cause symptoms and be clinically apparent.

INFECTION PREVENTION AND CONTROL (IPC)

is a practical, evidence-based approach preventing patients and health workers from being harmed by
avoidable infections.
DEFINITION OF TERMS
TRANSMISSION
the passing of a disease from an infected individual or group to a previously uninfected individual or
group.

PERSONAL PROTECTIVE EQUIPMENT (PPE)

• is an equipment worn to minimize exposure to hazards that cause serious workplace injuries and
illnesses.
• Specialized clothing or equipment worn by an employee for protection against infectious materials
-Occupational Safety and Health Administration
WHAT IS THE
CHAIN OF
INFECTION?
STANDARD
PRECAUTIONS
• Infection prevention practices used to avoid the
transmission of infectious agents, used with any patient,
regardless of their known or suspected infection status.
• Assumes any patient’s blood or body fluid may be
infectious.
TRANSMISSION-BASED
PRECAUTIONS
• added measures to prevent the spread of
disease from patients with known or
suspected disease
 THREE PRINCIPAL
ROUTES OF TRANSMISSION

CONTACT DROPLET AIRBORNE

 CONTACT
TRANSMISSION
DIRECT CONTACT
occurs when microorganisms are transferred from one infected
person to another person without a contaminated intermediate
object or person.

INDIRECT CONTACT
involves the transfer of an infectious agent through a
contaminated intermediate object or person.
 DROPLET
TRANSMISSION
Respiratory droplets carrying infectious pathogens transmit
infection when they travel directly from the respiratory tract of
the infectious individual to susceptible mucosal surfaces of the
recipient, generally over short distances, necessitating facial
protection.

Respiratory droplets are generated when an infected person

coughs, sneezes, or talks or during procedures such as suctioning,
endotracheal intubation, cough induction by chest physiotherapy
and cardiopulmonary resuscitation.
 DROPLET
TRANSMISSION
• Bordetella pertussis
• Influenza virus
• Adenovirus
• Rhinovirus
• Mycoplasma pneumoniae
• SARS associated coronavirus (SARS-CoV)
• Group A streptococcus
• Neisseria meningitidis
 AIRBORNE
TRANSMISSION
occurs by dissemination of either airborne droplet nuclei or small
particles in the respirable size range containing infectious agents
that remain infective over time and distance.

Microorganisms carried in this manner may be dispersed over

long distances by air currents and may be inhaled by susceptible
individuals who have not had face-to-face contact with (or been in
the same room with) the infectious individual.
 AIRBORNE
TRANSMISSION
• Mycobacterium tuberculosis
• Rubeola virus (measles)
• Varicella-zoster virus (chickenpox)
OTHER SOURCES OF INFECTION
VEHICLE
e.g., contaminated food, water, or medications

VECTOR-BORNE
transmission of infectious agents from mosquitoes, flies, rats, and other
vermin
 PERSONAL PROTECTIVE EQUIPMENT
refers to a variety of barriers and respirators used alone or in combination to protect mucous
membranes, airways, skin, and clothing from contact with infectious agents. The selection of
PPE is based on the nature of the patient interaction and/or the likely mode(s) of transmission.

gloves isolation gown face mask face shield

 GLOVES
are used to prevent contamination of healthcare personnel hands
when:

1. anticipating direct contact with blood or body fluids, mucous

membranes, non-intact skin and other potentially infectious
material;

2. having direct contact with patients who are colonized or

infected with pathogens transmitted by the contact route

3. handling or touching visibly or potentially contaminated

patient care equipment and environmental surfaces.

4. Insertion point of a patient’s invasive or indwelling device

 GLOVES
• can protect both patients and healthcare personnel from exposure
to infectious material that may be carried on hands.

• necessary to change gloves during the care of a single patient to

prevent cross-contamination of body sites

• Discarding gloves between patients is necessary to prevent

transmission of infectious material.

• Gloves must not be washed for subsequent reuse because

microorganisms cannot be removed reliably from glove surfaces
and continued glove integrity cannot be ensured.

• glove reuse has been associated with transmission of MRSA and

gram-negative bacilli.
GLOVES
• When worn in combination with other PPE, they
are put on last.

• Gloves that are removed properly will prevent

hand contamination.

• Hand hygiene following glove removal further

ensures that the hands will not carry potentially
infectious material that might have penetrated
through unrecognized tears or that could
contaminate the hands during glove removal.
REMEMBER!
• Select correct type of glove and size
• Extend to cover wrist, over isolation gown if worn
• Gloves are often the LAST item to be PUT ON
• There are a variety of ways to safely remove gloves
• With the gloved hand, grasp the palm area of the other
gloved hand and peel off
• Hold removed glove in gloved hand; slide fingers of
ungloved hand under remaining glove at wrist, peel off and
discard
• Gloves are usually the FIRST item to be REMOVED
 ISOLATION GOWNS
• used as specified by Standard and Transmission-
Based Precautions, to protect the HCW’s arms
and exposed body areas and prevent
contamination of clothing with blood, body
fluids, and other potentially infectious material.

• wearing of isolation gowns and other protective

apparel is mandated by the OSHA Bloodborne
Pathogens Standard.

• Clinical and laboratory coats or jackets worn over

personal clothing for comfort and/or purposes of
identity are NOT considered PPE.
 ISOLATION GOWNS
Wear when contact between clothing or skin with
patient blood or body substances is expected. For
example:

• Contact with patient’s non-intact skin

• During procedures likely to generate a splash or

spray of blood or body fluid

• Handling containers or patient fluids likely to

leak, splash or spill
 ISOLATION GOWNS
• always worn in combination with gloves, and with
other PPE when indicated.

• usually the first piece of PPE to be donned.

• Full coverage of the arms and body front, from

neck to the mid-thigh or below will ensure that
clothing and exposed upper body areas are
protected.

• should be removed before leaving the patient care

area to prevent possible contamination of the
environment outside the patient’s room.
REMEMBER!
• Gowns should cover the torso, the legs to the knees, the arms to
end of wrist and wrap around the back
• Slide gowns on with the opening at the back, fasten around the
back of the neck and the waist
• Unfasten gown
• Pull away from neck and shoulders, touching inside of gown
only
• Turn gown inside out
• Fold or roll into a bundle and discard
• Remove gown and perform hand hygiene before leaving the
patient’s environment
• Do not wear the same gown between patients
 MASK
• used for three primary purposes in healthcare settings:

1. placed on healthcare personnel to protect them from

contact with infectious material from patients

2. placed on healthcare personnel when engaged in

procedures requiring sterile technique to protect patients
from exposure to infectious agents carried in a healthcare
worker’s mouth or nose, and

3. placed on coughing patients to limit potential

dissemination of infectious respiratory secretions from the
patient to others
 MASK
• may be used in combination with goggles to
protect the mouth, nose and eyes

• should not be confused with particulate

respirators that are used to prevent inhalation of
small particles that may contain infectious agents
transmitted via the airborne route.
REMEMBER!
• Secure ties or elastic bands at middle of head and neck
• Flexible band should fit to bridge of nose
• Face mask should fit snug to face and below chin
• Fit-check respirator
• Grasp bottom ties or elastics of the face
mask/respirator, then the ones at the top, and remove
without touching the front
• Discard in waste container
 GOGGLES/ FACE SHIELD
• eye protection chosen for specific work situations depends
upon the circumstances of exposure, other PPE used, and
personal vision needs.

• Personal eyeglasses and contact lenses are NOT considered

adequate eye protection.

• must be comfortable, allow for sufficient peripheral vision,

and must be adjustable to ensure a secure fit.

• face shield can provide protection to other facial areas in

addition to the eyes. Face shields extending from chin to
crown provide better face and eye protection from splashes
and sprays; face shields that wrap around the sides may
reduce splashes around the edge of the shield.
 GOGGLES/ FACE SHIELD
• Removal of a face shield, goggles and mask
can be performed safely after gloves have been
removed, and hand hygiene performed.

• The ties, ear pieces and/or headband used to

secure the equipment to the head are
considered “clean” and therefore safe to touch
with bare hands.

• The front of a mask, goggles and face shield

are considered contaminated.
REMEMBER!
• Wear when anticipating potential splashes or sprays of
blood/body substances during patient care
• Face Masks–protect nose and mouth
• Goggles–protect eyes
• Face shields–protect face
• Personal eyeglasses and contact lenses are not considered
adequate eye protection
• Place over face and eyes and adjust to fit
• Remove from the back by lifting the head band over the ear
piece
• Place in designated area for reprocessing or disposal
RESPIRATORY
PROTECTION
• Respiratory protection currently requires the use of a respirator with
N95 or higher filtration to prevent inhalation of infectious particles.

• CDC currently recommends N95 or higher level respirators for

personnel exposed to patients with suspected or confirmed of diseases
that can be transmitted through to airborne route.

• Respirators are also currently recommended to be worn during the

performance of aerosol-generating procedures on patients with SARS
Co-V infection, avian influenza and pandemic influenza.
 AEROSOL GENERATING
PROCEDURES
• Aerosolized or nebulized medication administration
• Diagnostic sputum induction, Chest Physiotherapy
• Bronchoscopy
• Airway suctioning
• Intubation, CPR
• Positive pressure ventilation via facemask
PROPER
DONNING OF
N95
RESPIRATOR
PROPER DONNING OF
N95 RESPIRATOR
• Cup the respirator in your hand with the

01 nosepiece at your fingertips allowing the

headbands to hang freely below your hand

02 • Position the respirator under your chin

with the nosepiece up
PROPER DONNING OF
N95 RESPIRATOR
• Pull the top strap over your head resting it high

03 at the back of your head. Pull the bottom strap

over your head and position it around the neck
below the ears

• Place fingertips of both hands at the top of the metal

04
nosepiece. Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose. Pinching the
nosepiece using one hand may result in less effective
respirator performance
PROPER DONNING OF
N95 RESPIRATOR

• Cover the front of the respirator with both

05 hands, being careful not to disturb the

position of respirator
PARTICULATE RESPIRATOR
SEAL CHECK
POSITIVE
• Exhale sharply. A positive pressure inside the
respirator = no leakage. If leakage, adjust position
and/or tension straps.
• Retest the seal and repeat the steps until respirator is
sealed properly

NEGATIVE
• Inhale deeply. If no leakage, negative pressure will make
respirator cling to your face
• Leakage will result in loss of negative pressure in the
respirator due to air entering through gaps in the seal
PROPER
DOFFING OF
N95
RESPIRATOR
PROPER DOFFING OF N95
RESPIRATOR
• Lift the bottom strap over your head first
• Then lift off the top strap
• Discard
PROPER
SEQUENCE OF
PUTTING ON
OR DONNING
PUTTING ON OR DONNING
OF PPE
The putting on or “donning” of PPE should be done
before coming into contact with the patient or
situation.

Before entering the isolation room/area:

–Attend to personal necessities
–Gather all equipment needed
 DONNING OF PPE

GOWN MASK FACE SHIELD GLOVES

GOWN MASK
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
PROPER
SEQUENCE OF
PUTTING OFF
OR DOFFING
PUTTING OFF OR DOFFING
OF PPE
The key for PPE removal is to limit opportunities
for environment and self-contamination

Designated containers for used disposable or reusable PPE should

be placed in a location that is convenient to the site of removal to
facilitate disposal and containment of contaminated materials.
 DOFFING OF PPE

GLOVES FACE SHIELD GOWN MASK

GLOVES GOWN MASK

KEY POINTS
• Selection of PPE is based on the nature of the patient
interaction and potential for exposure to infectious material
• Put on (don) PPE prior to coming into contact with the
patient
• Be aware of self-contamination when PPE is used
• PPE should be removed (doffed) before leaving the patient
care area to prevent possible contamination of the
environment outside the patient’s room
• Properly discard all single-use PPE after use
• Perform hand hygiene after PPE removal
REFERENCES
• Guideline for Isolation Precautions: Prevent
ing Transmission of Infectious Agents in He
althcare Settings (2007) (cdc.gov)
• Personal Protective Equipment (PPE) 101 (
cdc.gov)
• https://infectionpreventionandyou.org/prote
ct-your-patients/break-the-chain-of-infectio
n/
QUESTIONS?
KNOWLEDGE CHECK
evaluation form
Kindly SCAN the QR Code below and answer the
feedback form. Once submitted, an E-Certificate of
Attendance will be sent to your e-mail address.

https://forms.gle/7XcsE3G7CPN5G5G4A