PPE Precautions (Personal Protective Equipment) for Certified Perioperative Nurse (CNOR)

PPE Precautions (Personal Protective Equipment)

Guidelines:

• Standard Precautions
  • First tier of infection prevention, most important strategy for infection control
  • Applies to ALL patients regardless of infection status
  • Includes:
    • Hand Hygiene
    • Gloves
    • Mask
    • Eye protection
    • Face shields
    • Gowns
    • Sharps
    • Patient care equipment
    • Linens
    • Environmental control
    • Patient placement
• Transmission-Based Precautions
  • Second tier of infection prevention
  • Known or suspected infection by pathogens
  • Airborne, droplet, or contact
  • Appropriate PPE dependent on mode(s) of transmission

Considerations:

• Airborne
  • Microorganisms transmitted by small particles
  • OSHA-specified respiratory protection
  • Example, TB
  • Surgical mask for patient when transported
• Droplet
  • Microorganisms transmitted by large droplets
  • Wear a mask when within 3 feet of patient
  • Place mask on patient when transported
• Contact
  • Organisms transmitted by direct or indirect contact
  • Gloves, Gowns, hand hygiene

Nurse’s role:

• Use PPE to prevent exposure to blood, body fluids, and other potentially infectious materials
• Select gown and mask type according to task and exposure. Higher levels mean higher protection
• Use airborne, droplet, and contact precautions, as necessary, during patient transport
• Instruct visitors to wear PPE when patient is under transmission-based precautions
• Hand hygiene vigilance

Pitfalls:

• Health care personnel frequently fail to use PPE correctly
• Incorrect PPE removal can lead to self-contamination with potential pathogens
• Remove PPE in a sequence that prevents touching contaminated portions of the PPE
  • Outside of gown/gloves
  • Front of the eye protection
  • Front of mask
• During patient transport, wear PPE according to organizational policy and when direct contact with patient is necessary

Examples:

• You are transporting a patient from the OR to the PACU and the patient is on contact precautions. You are unsure whether or not you need to wear a gown while transporting the patient to PACU. What information must you consider before determining the correct action?

Linchpins (Key Points):

• PPE is key!
• Hand Hygiene Vigilance is a must!
• Standard = First Tier, Most important
• Transmission-Based = Standard + additional precautions per mode of transmission