Covid-19: Putting on personal protective equipment (PPE)

Many of our agency nurses have come to us regarding the use of personal protective equipment (PPE) whilst on shift, more specifically the putting on (donning) and taking off (doffing) of PPE. The correct application and removal of PPE is critical at this time for agency nurses to help protect the wearer, prevent the spread of the virus and ultimately save lives.

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The following guidance has come from Public Health England who have provided a number of extremely useful and informative guides on the use of personal protective equipment for aerosol generating procedures, please consult these guides and make yourself familiar with the procedures.

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This two-minute blog aims to cover the type of PPE required and how to put it on safely.

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Recommended PPE Components

•  A long, rear fastening, fluid resistant long sleeved surgical gown;

• A fit-tested FFP3 respirator (there are a number of approved respirators)

• A disposable full face visor or googles

• Gloves in the correct size

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Pre-donning Instructions

This process should be carried out outside the patient's room and ideally supervised by a buddy at a distance of at least two metres. The buddy should be trained and competent in the use of PPE and can assist with putting on the PPE and carrying out a final visual inspection. If you don't have a buddy carry out self inspection after each step. Before donning PPE ensure that you have thoroughly performed hand hygiene.

• Ensure you're hydrated

• Tie hair back

• Remove jewellery

• Check PPE in the correct size is available

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Step One

1. Put on a long, rear fastening fluid resistant and long sleeved disposable gown

2. Do not use the inside tie

3. Fasten the neck tie/velcro and waist ties

If you wear glasses, remove them before fitting respirator, ensure they're clean using an alcohol wipe and replace them before you don your visor.

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Step Two

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1. Put on respirator and check the fit (It must be the respirator that you are face fit-tested to use)
   - Your respiratory must be compatible with other facial protection
   - If you haven't been fit-tested for the particular mask you shouldn't enter the patient’s room

2. Position the upper straps on the crown of your head, above the ears and the lower strap at the nape of the neck. Ensure that the respirator is flat against your cheeks.

3. With both hands mould the nose piece from the bridge of the nose firmly pressing down on both sides of the nose with your fingers until you have a good facial fit.
   - Always perform a fit check before entering the work area
   - Ensure there is no air leaking from the edges of the respirator
   - For non-valve respirator, exhale sharply to test
   - For a valved product, inhale sharply
   - If air flows around the nose, adjust the nose piece
   - If air flows around the edges of the respirator readjust headbands
   - If you are unable to obtain a successful fit check DO NOT enter the work area
   - If you wear glasses, put them back on before progressing to the next step

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Step Three

1. Put on your eye protection, a full face visor is preferable

2. If a visor is unavailable googles must be used

3. If you do use a visor, make sure that it covers the entirety of your face including your chin

4. Adjust your headband to fit

5. If you don't have a buddy, use a mirror to ensure that the visor is in the correct position

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Step Four

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1. Put on a pair on non-sterile, nitrile gloves that are the correct size

2. Ensure the gloves cover the cuffs of the gown completely

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Complete Final PPE Item Fit Check

• Check that the gown ties at the neck and waist are secure

• The respirator is correctly fitted

• The visor is in position

• The gloves cover the cuffs

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Once you're satisfied that all of the steps have been completed properly, you are now ready to enter the patient area. For a complete visual demonstration of donning PPE, Public Health England have produced a handy video which can be found here.

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We've also sourced the government's advice for doffing PPE and complied it into a blog for our agency nurses which can be found here.

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Whether you’re a Healthcare Assistant, Registered General Nurse or an Emergency Nurse Practitioner if you’re interested in working through the UK’s premium nursing agency as an agency nurse register today.