Infection prevention and control guidelines

3. Personal protective equipment

General principles of personal protective equipment use

      1. General principles of personal protective equipment use

General principles of personal protective equipment use

Personal protective equipment refers to a variety of barriers (eg gloves, fluid-resistant aprons, gowns, masks, purpose-designed protective glasses, goggles, full face shields) used to protect mucous membranes, airways, skin and clothing from contact with blood and body substances (including airborne infectious agents from the respiratory tract) or with contaminated objects/surfaces (Table 3.1. Recommended use and characteristics of personal protective equipment).

The appropriate use of personal protective equipment depends on the situation and the assessed risk to staff or patients. Factors to consider include the probability of exposure, the type of body substance involved, and the probable type and route of transmission of microorganisms. For example, examination gloves are used as a standard precaution for low-risk procedures where there is a likelihood of exposure to a patient’s blood or body substance, whilec P2/N95 masks may be needed during a respiratory disease outbreak.

When used as part of standard precautions (see 5. Levels of precaution), personal protective equipment protects against anticipated exposure to blood or other body substances. When used as part of transmission-based precautions,  Transmission-based precautions always include standard precautions. personal protective equipment serves as a physical barrier against the specific modes of transmission identified in risk assessment.  Droplet and airborne modes of transmission are closely interrelated because the relevant infectious matter represents a continuum from large droplets to small particles. Infection prevention and control strategies for these modes overlap substantially. While some experts consider them as one mode of transmission, this guideline retains the distinction between droplet and airborne transmission for consistency with current national guidelines.  

Table 3.1. Recommended use and characteristics of personal protective equipment

Item

Use

Characteristics

Sterile surgical gloves

To prevent contact between health worker’s skin and patient’s body, or body substances, during aseptic procedures or surgical procedures

Single-use for one procedure

Flexible and tightly fitting to avoid compromising wearer’s dexterity

Composed of latex, synthetic latex or synthetic elastomer

Disposable

Nonsterile examination gloves

To prevent contact between health worker’s skin and patient’s body, or body substances, during procedures that require a ‘no-touch’ technique

Single-use for one procedure

Composed of latex or synthetic materials (eg vinyl, nitrile, or neoprene)

Disposable

General-purpose utility gloves

To prevent contact between staff member’s skin and blood/other body substances or contaminated equipment or surfaces

Multiple use, for activities that do not involve patient care, such as cleaning surfaces

Longer cuff

Composed of nitrile, latex or combined material

Chemically resistant

Puncture-resistant

Reusable (after washing) or disposable

Heavy-duty protective gloves

To prevent contact between staff member’s skin and blood/other body substances, contaminated objects or chemicals

For instrument cleaning or other activities with a high risk of contact with blood, other body substances, contaminated objects, sharps or chemicals

Multiple use, for activities that do not involve patient care

Uncomfortable and potentially hazardous due to poor dexterity and touch sensitivity

Heavy-duty

Puncture-free

Chemical-resistant

Washable

Surgical mask

To provide a physical barrier between the mouth and nose of the wearer and the surrounding air.

Worn by :

  • health workers during surgery, or when in close proximity to patients, or whenever droplet precautions required to prevent droplet transmission
  • patients with respiratory infection or cough
  • community during a respiratory pandemic.

Single-use, for one procedure or episode of patient care

Fluid-resistant

Ties or ear loops

Disposable

N95/P2 mask

To protect wearer and others from exposure to airborne particles including pathogenic airborne particulates such as viruses and bacteria

Single-use, for one procedure or episode of patient care (see also Extended use of personal protective equipment)

Close seal around nose and mouth (fit-tested; fit check required at time of use)

Levels of particulate filtration depends on grade (eg N95 respirators are effective in removing a minimum of 95% of solid and liquid aerosols that do not contain oil)

Two head loops (not ear loops)

Disposable

Eye protection

When performing procedures where there is a risk of splashing or spraying of blood or body substances (eg surgical procedures, venipuncture, cleaning of reusable medical equipment)

For single or multiple use, depending on type

Includes goggles, safety glasses, and full-face shields

Clear, anti-fogging material

Efficacy depends on seal around eyes (goggles provide more effective seal than safety glasses)

Face shield

For additional protection from splash contact during procedures or cleaning

For additional protection from droplets (eg coughing, sneezing) while wearing a mask

Single-use

Clear, anti-fogging material

Extends around to ears and below chin

Plastic apron

When there is the possibility of sprays or spills or exposure to blood or body substances during low-risk procedures

During contact precautions when patient contact is likely

Single-use, for one procedure or episode of patient care

Fluid-resistant

Disposable

Nonsterile gown

To prevent contamination of healthcare worker’s limbs or clothing with blood, other body substances, or other potentially infectious material

When there is a risk of contact of the healthcare worker's skin with a patient's broken skin, extensive skin to skin contact (eg lifting a patient with scabies)

When there is a risk of contact with blood and uncontained body substances (eg vomiting)

When there is a possibility of extensive splashing of blood and body substances or risk of exposure to large amounts of body substances (eg in some operative procedures)

Usually single use (see also Extended use of personal protective equipment)

Fluid-resistant

Long sleeved and cuffed so clothing and exposed upper body areas are protected

Generally worn in combination with gloves and with other personal protective equipment when indicated

Sterile gown

During procedures that require surgical aseptic technique (if required based on risk assessment)

Single-use, for one procedure or episode of patient care

Pre-packaged in sterile pack

Source: National Health and Medical Research Council,1 Therapeutic Goods Administration2

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