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.
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.
This two-minute blog aims to cover the correct order and removal of PPE safely.
This process should be carried out in a systematic way before leaving a patient's room. You MUST NOT remove your respirator until you are outside the patients room. Ideally the doffing process should be supervised by a buddy at a distance of at least two metres, this is to reduce the risk of the healthcare worker removing PPE and contaminating themselves during removal. The buddy should be trained and competent in the use of PPE and can assist with removing the PPE. Your respirator should be removed once you are in the anteroom/lobby. If you don't have a anteroom/lobby remove respirator in a safe area.
All PPE must be disposed of as healthcare waste.
Step One - Gloves
REMEMBER - The outside of the gloves are contaminated.
1. Hold the outside of the glove with the opposite gloved hand and peel it off
2. Hold the removed glove in the gloved hand
3. Slide the fingers of the un-gloved hand under the remaining glove at the wrist
4. Peel the remaining glove off over the first glove and discard in a clinical waste bin
5. Clean your hands with alcohol gel
Step Two - Gown
REMEMBER - The front of the gown and the sleeves will be contaminated.
1. Unfasten the neck tie
2. Unfasten the waist ties
3. Pull gown away from the neck and shoulders, touching the inside of the gown only using a peeling motion as the outside of the gown will be contaminated
4. Turn the gown inside out, roll into a bundle and discard into a clinical waste in
Step Three - Eye Protection
REMEMBER - The outside will be contaminated.
Whilst standing up straight, use both hands to handle the retaining straps by pulling away from behind
Discard eye protection in a clinical waste bin
Leave the patients room
Wash hands and wrists with alcohol hand rub
Step Four - Respirator
REMEMBER - In the absence of an anteroom/lobby remove respirators in a safe area.
DO NOT TOUCH THE FRONT OF THE RESPIRATOR AS IT WILL BE CONTAMINATED
Lean forward slightly
With both hands find the bottom retaining strap at the back of the head and bring it up to the top strap
Lift both straps over the top of the head
Let the respirator fall away from your face
Place in clinical waste bin
Step Four - Wash Your Hands
Wash your hands thoroughly with soap and water
For a complete visual demonstration of donning PPE, Public Health England have produced a handy video which can be found here. We've also sourced the government's advice for donning PPE and complied it into a blog for our agency nurses which can be found here.