Healthcare-associated infection prevention

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Protective equipment against infectious agents

Protective equipment to prevent infectious agents must always be used in conjunction with other infection prevention measures and work methods to break the chain of transmission.

Protective equipment is intended to protect individuals against infectious substances by breaking the chain of transmission.

• Gloves are used to protect against infection by contact.

• Protective masks: operating room or fine particle masks to protect against inhalation of airborne infectious agents (respiratory aerosols and sprays).

• Eye protection to protect against splashes/irritation of bodily fluids.

• Protective gowns protect work clothes and skin from contact with infectious agents.

Those who use protective equipment need to be trained in its use, and it is necessary to monitor its usage.

Sensible use of protective equipment

• The choice of protective equipment used in each case is based on the infectious agent and the route of transmission that needs to be broken. The risk must be defined in each case, and what equipment is required.

• Avoid reusing protective equipment manufactured as disposable. It is still being determined whether such reuse of disposable equipment provides the same protection as before or can potentially increase the risk of infection.

• Suppose supplies are limited and disposable protective equipment is unavailable. In that case, reusable equipment (e.g. cotton gowns that can be washed and sterilised with heat) should be used and disinfected after each use.

• Waste should be avoided, and equipment needed in each case should be critically evaluated.

Protective masks for protection against inhalation of infectious agents

• Protective masks are of various types, e.g. "operating room masks", "fine particle filters", full masks with fresh air equipment, etc. A safe factor is used, indicating how much the mask reduces pollution. A mask with a safety factor must be selected based on the contamination limit, the contamination and conditions in each case.

• Particulate-only respirators/filters are classified according to the amount of particulate they can filter from the atmosphere into FFP 1 (safety factor 4), FFP 2 (safety factor 10), and FFP 3 (safety factor 20), with FFP 3 providing the best protection.

• Fine particle masks (FFP 2 and FFP 3) must fit the user's face and be completely tight. If the mask gets wet or gets dirty with water, the mask must be changed immediately. You should throw the used mask in the trash immediately and use alcohol or wash your hands afterwards.

• Training employees is essential to ensure the correct use of fine particle masks.

• Teach and train:

  • how to put on a fine particle mask

  • how to check how tightly the mask fits the face (pressure test)

  • how to avoid contaminating the mask during use

  • how to take off the mask

  • how to dispose of a used mask

• Suppose patients with the same infectious respiratory disease are collected together in group isolation or are in several adjoining rooms in a medical ward. In that case, the worker may wear the same particulate mask during a work shift. During such use of a particulate mask, the worker must not take off the mask during the work session and must not touch it. If the mask gets wet or becomes contaminated, e.g. upon contact, the mask must be changed immediately.

Eye protection

• Eye protection protects the mucous membranes of the eyes against splashes/irritation of bodily fluids. It is thus part of basic hygiene precautions that should always be used if it is considered probable that bodily fluids may be contaminated. Eye protection is classified as standard equipment for personnel during accidents and surgeries.

• Eye shields can be part of protective equipment during care in a healthcare facility if the patient's infectious agent has an affinity for the mucous membrane of the eyes.

• Eye shields can be disposable or reusable. Reusable eye protection must be cleaned and disinfected after each use. Hand cleaning is required after touching used eye protection (taken down after use and after cleaning).

• Regular glasses are not designed to protect the mucous membrane of the eyes against mist and splashes and, therefore, cannot replace eye protection.
  

Gloves

• Gloves are used for basic precautions against infections, i.e. when touching blood, body fluids, mucous membranes, or broken skin.

• Gloves can be part of protective equipment, i.e. isolation against contact infection is carried out.

• Gloves must be changed when moving between tasks that may contaminate the gloves when caring for the same person.

• Remove gloves immediately after use, before touching clean surfaces, and before attending to the next patient.

• Clean hands with alcohol or hand wash immediately after removing gloves.
  

Protective gowns

• Protective gowns protect clothing against contamination, splashes, and blood and bodily fluids contamination.

• Protective gowns can be part of protective equipment, i.e. isolation against contact infection.

• A protective gown must be chosen according to how much moisture needs to be protected. If a lot of wetness is expected or a large amount of infectious agent is being protected, and the gown is not waterproof, a waterproof apron must be worn over the dress.

• Please remove the protective gown as soon as the work is finished, throw it in the trash, or put it in a bag for dirty linen. Clean your hands afterwards.

Putting on and taking off protective equipment

The choice of protective equipment used in each case is based on the infectious agent and the route of transmission that needs to be broken.

• Define the risk and what equipment is required.

• Find all the equipment you need.

• Clean hands with hand sanitiser or by washing hands with soap and water.

• Put on and remove the protective equipment in the correct sequence to ensure that it protects you from the infectious agent while you are wearing it and to reduce the chance of contagious agents from outside the equipment being transferred to you when you take it off.

Putting on protective equipment

The correct sequence when putting on protective equipment (when it is necessary to use what is considered here):