PPE is used throughout the healthcare industry; it is any equipment that protects its user from health or safety risks at work, including cross-infection. When dealing with known or suspected ill individuals, organizations must provide instructions, procedures, training, and supervision to encourage staff to operate safely and responsibly, including the use of PPE.

Organizations should be clear about when PPE is required and never deviate from the rules, such as telling a nurse that she doesn't need to wear gloves because the procedure will "only take a few seconds" or a care assistant that he doesn't need an apron. After all, "the patient's symptoms have subsided."

Deviation from the rules regarding PPE puts everyone in a setting at risk, including visitors such as contractors or relatives of nursing home residents who have come to visit.

When is PPE required?

Personal protective equipment (PPE) should be used whenever an employee's health or safety is at danger on the work. However, despite the widespread use of Health and Safety, Executive guidance on PPE in healthcare settings maintains that it should only be used as a last resort when other risk control measures are ineffective.

In a healthcare setting, the following situations call for the use of various types of PPE:

The dangers of handling sharp objects and dirty machinery

While assisting patients with activities of daily living

When there is a danger of getting blood or other bodily fluids splashed into the face and eyes

Since there is a higher chance of blood or bodily fluids flowing, as there is in an operating room, more safety measures must be followed.

While administering injections or repositioning patients, both of which might spread germs, it's important to wear protective gear.

When performing activities that pose a risk of infection transmission, such as giving injections or moving and positioning patients.

This is by no means an all-inclusive list, and the items on it change depending on the nature of the activity and its setting.

The doctor has put on gloves in preparation for giving an injection.

The rationale for PPE

Protective equipment (PPE) in the healthcare industry is worn by professionals who may be exposed to patients' bodily fluids, which may include infectious agents like bacteria and viruses, while doing their jobs.

Therefore, PPE acts as a barrier that helps reduce the potential spread of infection within a setting, protecting healthcare workers, patients, visitors, and anyone else within the setting.

Regardless of the likelihood of contact with bodily fluids, PPE should be worn by all healthcare workers whenever possible.

Risk assessment for PPE and infection control

The onus of detecting risks and preventing exposure to hazards, including those that may require PPE, such as body fluids, lies squarely on the shoulders of employers.

Step 1 – Determine the hazards: Any procedure where an employee interacts with someone who has an infection (whether knowing or not) will have their risk of contracting an infection enhanced.

The risk varies widely according to the action being performed; some practice areas have a minimal risk of infection, while others have a continuously high risk.

Whenever time a worker has a chance of coming into contact with blood or another potentially infectious substance, the risk to the entire company must be assessed.

Step 2: Determine who could be harmed and how Legislation regarding infection control applies to all employees who work within an organization, as well as Those who are self-employed in the setting and those who work for an agency, such as bank workers, are excluded and those who are contracted by other businesses to perform services such as catering and cleaning.

When utilizing them, employees who have direct contact with sick patients may be exposed to the following risks:

Clinical actions include blood collection, cannula insertion, and immunization administration.

Chores include cleaning, transporting, and ensuring the sterility of supplies.

Labor performed in a laboratory

Work performed at a morgue.

Healthcare professionals such as nurses, physicians, and phlebotomists fall into this category.

The greatest danger of infection is posed by those who use medical equipment and have direct contact with sick persons.

However, other personnel, such as cleaning staff, remain at risk, such as cleaners and other auxiliary employees who may be in danger of infection from improperly discarded equipment and linens.

Step 3: Assess the hazards and determine preventative measures.

An effective risk assessment strategy is one that compares the status quo with benchmarks of best practice. The potential for harm arising from this comparison should be minimized by conducting an analysis to ascertain whether or not it can be completely avoided.

COSHH Rules mandate a hierarchical strategy to prevent the spread of infection:

1. Avoiding exposure risk - The total elimination of a danger

2. Reducing the danger of exposure - By implementing efficient work procedures

3. The control of exposure at the source - by implementing work practice restrictions

4. Personal protective equipment (PPE) - For example, the proper use of gloves and masks

5. supported by administrative controls, training, and information

Doctors ensure they are protected while working by wearing the proper PPE

Administrative measures that restrict exposure to risks.

Administrative controls guarantee that the correct information about best practices is accessible to all employees and that employees have access to training appropriate to their position. The following are examples of administrative controls:

Assuring that every employee is aware of their health and safety obligations

A comprehensive infection control policy is in place, covering injury and disease prevention, as well as follow-up treatment and education.

The elimination of all hazardous equipment

Safe work procedures are in place in high-risk environments, such as operating rooms.

All personnel receive consistent information and training on the proper use and disposal of medical equipment.

Selecting the optimal PPE for maximum effectiveness

The nature of the activity being performed by healthcare professionals will dictate the sort of PPE that should be made available to those conducting the task.

But healthcare personnel must also consider the fit and comfort of PPE while selecting the appropriate products to employ. Providing healthcare workers with PPE that is both comfortable and well-fitting increases the likelihood that they will actually use it, which in turn increases the likelihood that patients and staff will be protected.

The workplace should have a PPE policy that specifies when and what type of personal protective equipment (PPE) should be utilized. All medical personnel must be aware of the contents of this policy and should consult a supervisor or management if they have any questions regarding the proper use of PPE.

Commonly employed types of PPE

Below are the most popular types of PPE that most employees utilize in typical circumstances:

Gloves: Gloves must be worn before performing any task involving contact with body fluid. Then, they must be removed soon after completion. Before aiding with any operation involving direct contact with a patient, employees must confirm that the patient is not allergic to latex. Most gloves used in healthcare settings are produced from this material, and an alternate material must be made accessible by the employer.

Overshoes: They are worn to avoid spreading infection through the floor. They are utilized most frequently in clinical settings when staff interacts with patients who have undergone surgical operations or been kept in isolation.

Using gloves and an apron together is recommended if there is a risk of contact with blood or other body fluids. They must be removed immediately upon completion of the task and disposed of by government guidelines.

Face shields, including goggles, are essential when interacting with someone infected or when the employee's face or eyes are splattered with body fluid. Every surgical mask should cover the face and nose to prevent the inhalation or exhalation of pathogens. Respirator masks are worn when the danger of infection is extremely great and when an illness has the potential to be fatal.

Single-session application of PPE

Single-sessional use of PPE refers to a situation in which a healthcare professional performs tasks in a particular clinical location or environment, such as a specific hospital ward.

The session' about PPE concludes when the healthcare worker departs the specific location or environment; therefore, PPE is removed and disposed of safely at this point.

There is no predetermined duration for a session, as it varies according to the activities being conducted. Nonetheless, PPE should be removed and replaced if it gets damaged during a session or if it has been worn over the manufacturer-specified time limit.

Reusing PPE

Only items of PPE with instructions from the manufacturer stating that they are reusable should be reused. Work gloves, overshoes, and aprons are examples of consumables that are exempted from this rule.

Sometimes reusable PPE items include surgical gowns and coveralls.

Laboratory attire

Long-sleeve patient gowns

Visors Goggles.

Although some PPE equipment is reusable, they must still be fit for purpose and should be discarded if they become damaged or pass the manufacturer-recommended use-by date. They should be cleaned by local policy and never reused in a manner that could put the healthcare worker or others at risk.

Healthcare workers should know which PPE items are single-use and reusable; if uncertain, they should consult a supervisor or management.

Provisioning and upkeep of PPE

Legally, it is the employer's responsibility to provide appropriate PPE to employees responsible for its proper usage, maintenance, and disposal.

The PPE Rules and the Health and Safety at Work etc. Act of 1974 makes it criminal not only to fail to supply PPE when required but also to put persons in danger of injury.

The following should be considered when maintaining PPE to guarantee that it remains functional:

Are there available replacement parts, like filters for respirator masks, if it becomes damaged?

Are replacement things available if PPE becomes unexpectedly unusable?

Is it more economical to utilize single-use items?

Ensure that PPE is routinely inspected

Any damage to PPE must be reported immediately to line management.

Effective PPE maintenance may comprise cleaning and storing the equipment, and institutions should have a policy outlining how this is accomplished. In order to ensure that personal protective equipment (PPE) poses no risk, it should be cleaned by a competent cleaning service. It is the responsibility of the healthcare professional to maintain the functionality of the PPE that is taken home.

Storing PPE

Personal protective equipment (PPE) should be stored properly while not in use, i.e. in a place that is clean, dry, convenient, and free from situations that could damage it.

PPE should not be stored in a cluttered cabinet or on a high shelf; it should not be stacked, and equipment such as hooks and low shelving should be utilized.

When using PPE stored for an extended period, it must be tested to confirm that it is still within the manufacturer's use-by date.

In any environment where PPE is required, there should be signs alerting healthcare practitioners to this need. Some signs will be generic and refer to "PPE," while others will be more specific and list the kind of PPE that must be used, such as goggles or visors.

Anyone entering a location where such a sign is shown must obey it; refusal to do so puts that individual at risk and anyone else who may access the location.

After the emergence of the Covid-19 virus, the usage of PPE warning signs has become more popular and ubiquitous. The public is also expected to wear PPE (often face coverings) when visiting clinical facilities such as hospitals and general practitioners' offices.