ATrain Education

 

Continuing Education for Health Professionals

Bloodborne Pathogens: HBV, HCV, and HIV

Module 5

Personal Protective Equipment (PPE)

When to Wear PPE

[Material in this section is largely from OSHA, 2011.]

PPE is specialized clothing or equipment worn by an employee for protection against hazards that remain after engineering controls and work practice controls are in place. PPE is not the first line of defense! The employer must provide personal protective equipment, ensure that the employee uses and must clean, repair, and replace this equipment as needed.

The worker must decide when to wear PPE because exposure is likely. This is usually easy to determine:

If it is wet and not yours, stay out of it!

If exposure seems reasonably likely, you have the right to protect yourself with PPE. Wearing basic PPE is not optional.

PPE may include gloves, gowns, laboratory coats, face shields or masks, eye protection, resuscitation masks, and other protective gear. It must be readily accessible to employees and available in appropriate sizes.

Gloves shall be worn when:

  • It can reasonably be anticipated that the employee may have hand contact with blood, OPIM, mucous membranes and non-intact skin
  • Performing all vascular access procedures or procedures involving uncontained blood, such as finger or heel sticks
  • Gloves must be changed between patients (CDC, 2013c)

Single use gloves cannot be washed or decontaminated for reuse. Utility gloves may be decontaminated if they are not compromised. They should be replaced when they show signs of cracking, peeling, tearing, puncturing, or deteriorating.

Traditionally, latex gloves are used to avoid contact with blood or OPIM. However, some workers are allergic to latex. In most circumstances, nitrile or other glove alternatives may be used in place of latex gloves. Employers are required to provide non-latex alternatives to employees with sensitivities to latex and other materials.

Employees should wear eye and mouth protection such as goggles and masks, glasses with solid side shields, and masks or face shields when splashes, sprays, splatters, or droplets of blood or OPIM pose a hazard to eyes, nose, or mouth.

Gowns, aprons, surgical caps and hoods, and shoe covers or boots are needed when splash, spray, or gross contamination is expected. This may occur, for example, during labor and delivery.

Employers must provide the PPE and ensure that their workers wear it. This means that if a lab coat is considered PPE, it must be supplied by the employer rather than the employee. The employer also must clean or launder clothing and equipment and repair or replace it as necessary. This includes, but is not limited to dentistry, phlebotomy or processing of any body fluid specimen, and postmortem procedures.

Personal protective clothing and equipment must be appropriate for the level of protection needed for the expected exposure. For example, gloves would be sufficient for a laboratory technician who is drawing blood, whereas a pathologist conducting an autopsy would need considerably more protective clothing.

Personal protective equipment may be required during the care of any patient so it must be routinely available in patient care areas, not just on isolation carts. You may need to wear a mask and eye protection during the care of a patient on Standard or Universal Precautions. Availability of PPE is required by the OSHA Standard. If you are not sure where to obtain it, ask your employer.

Exception

The employer shall ensure that the employee uses appropriate PPE unless the employer shows that the employee temporarily and briefly declined to use PPE when, under rare and extraordinary circumstances, it was the employee’s professional judgment that in the specific instance its use would have prevented the delivery of healthcare or public safety services or would have posed an increased hazard to the safety of the worker or co-worker.

When the employee makes this judgment, the circumstances shall be investigated and documented in order to determine whether changes can be instituted to prevent such occurrences in the future. In other words, if using PPE would increase danger to the person receiving care or to the worker, then the worker may decline to use the PPE, but situations like this must be reported and investigated.

Decontaminating and Disposing of PPE

[Material in this section is largely from OSHA, 2013c.]

Employees must remove personal protective clothing and equipment before leaving the work area or when the PPE becomes contaminated. If a garment is penetrated, workers must remove it immediately or as soon as feasible. Used protective clothing and equipment must be placed in designated containers for storage, decontamination, or disposal.

While use of PPE cannot prevent all exposures, wearing it properly and when needed can greatly reduce potential exposure to all bloodborne pathogens.

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