How to don and doff PPE kit for covid-19 care
Meaning of PPE kit is Personal Protective Equipment. Based on the current available evidence, the COVID-19 virus is transmitted between people through droplet transmission when susceptible individuals come into contact with the respiratory secretions from a symptomatic person’s cough or sneeze.
It could also be transmitted through direct and indirect contact with contaminated surfaces and then touching his or her face. Highest risk of infection is those who are in close contact with a COVID-19 patient or who care for COVID-19 patients. Therefore, how as a healthcare worker you can best protect yourself when coming into contact with a suspected or confirmed COVID-19 patient.
About PPE
This is a guide by WHO for healthcare workers involved in patient care activities in a health care setting. It aims to show the type of personal protective equipment or PPE needed to correctly protect oneself according to risk assessment, and the procedure to be carefully followed to put them on and to remove them.
PPE is part of a larger infection control and prevention policy and should be conducted by educational posters and training. Only clinical person trained and competent in the use of PPE should be allowed to enter the patient’s care area. Safe putting on and removal of PPE should be done outside of the patients room, ideally in a dedicated area and either using a mirror or under the supervision of a trained observer (colleague).
Recommendation for PPE set
A long-sleeve, fluid resistant surgical gown. Disposable medical gloves. A medical mask, also known as a surgical mask, or respirator mask for aerosol generating procedures. Eyes protector like a face shield or goggles. Ensure you have all the necessary PPE and are able to put on the protective equipment outside of the patient’s room.
How to put on PPE correctly
To begin ensure staff has removed all jewelry and personal items and hair is tied back, if applicable. Make sure and consider the risk involved in the care you are going to provide to the patient to ensure using appropriate PPE for the precautions needed. Following are the steps to put on PPE correctly
Step 1. is to perform hand hygiene:
- The preferred method of alcohol hand rub for 20-30 seconds
- OR if not available or hands are visibly soiled, with water and soap for 40-60 seconds
- Clean your hands by rubbing them with an alcohol-based solution. It is the fastest and most effective method and better tolerated by skin.
- Follow the WHO technique that ensures all the surfaces of hands are carefully covered by the product and will eliminate the microorganisms on hands.
Process: for 20 – 30 seconds
- Apply the product into a cupped hand
- Rub hands together, rubbing palm to palm
- Rub the back of each hand with interlaced fingers
- Palm to palm with interlaced fingers
- Rotate the hands in a cupped shape
- Rub thumbs rotational
- Rub tips of fingers and nail beds in each palm, continue rubbing until hands are completely dry
- And now your hands are clean and safe to proceed with the PPE
Step 2. now you are ready to put on the PPE
- check the integrity of the equipment and do not use any damaged equipment.
Step 3. Now you are ready to put on the gown
- Tie back long hair if applicable.
- Inspect equipment for damage prior to donning each piece
- Put on gown, wrap around the neck and around the waist and securing the back
- Ensure all clothing is covered by the gown
Step 4. Now, place the medical or surgical mask on
- Ensure it is over your nose and mouth.
- Compress the metal piece to ensure a tight fit.
- Once the mask is safe on your face try not to touch it
- If it is necessary to touch the mask than perform hand hygiene before and after touching the mask.
Step 5. Next, put on the eye protection - goggles
- Option face shield which can be placed over the mask with the top resting in the middle of your forehead
Step 6. Finally, put on a pair of gloves
- Keep them on the cuff on the gown and make sure the skin does not come out
- You must check each piece of equipment at the end thoroughly and ensure that the equipment is placed on correctly.
- It might be helpful to have a buddy, a colleague who is competent in this procedure and could perform visual inspection
Now you are ready to enter the patient’s room!
How to remove PPE
The removal of PPE poses the highest risk of transmission to health care workers. Make sure to avoid any contact between potentially contaminated PPE and the clothes, skin, or your face. If possible respect the order in front of a partner or in the mirror. Following are the steps to remove PPE
Steps 1. The first step is to remove gloves
- Using the glove to glove and skin to skin technique.
- This is the most messy item which needs to be removed first and discarded safely.
Steps 2. Next, remove the gown
- Make sure gown is removed from the body by undoing the ties and ensuring that your cloths or environment are not contaminated.
- Turn the gown inside out and dispose of safely in the garbage or laundry hamper.
Steps 3. Next, perform hand hygiene
- With alcohol based hand rub for 20 seconds before touching your face
Steps 4. Remove the eye protection
- By bending forward and pulling them away from your face; be it face shield or goggles.
- Ensure you clean the goggles or the face shield if they are reusable and place them in a clean container.
Steps 5. Next, Remove the mask or N95/FFP2 / FFP3
- By pulling it from the rear and dispose of it in the disposal container or garbage.
- Make sure you are removing the mask with the straps, avoid touching the mask.
Steps 6. Now as a final step perform hand hygiene
- With alcohol based hand rub or with soap and water if they are visibly soiled.
Source
Staying up to date on nursing topics is an important task to keep in mind. Prof. R. P. Saxena founder of www.communityhealthnursing.guru has created this site during COVID-19 Pandemic for all Nursing students, Professional Nurses and Public to keep in touch with current trend in the subject of nursing to excel in their careers. I hope this site will be very useful to all.