Guidelines on the Prevention and Control of Tuberculosis in Ireland

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<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCClinicalWorkPracticeUse ofPersonalProtectiveEquipment(PPE)ClinicalWorkPracticeUse ofPersonalProtectiveEquipment(PPE)STANDARD PRECAUTIONS AIRBORNE PRECAUTIONSType and selection ofPPEPPE consists of:• Gloves,• Aprons/gowns• Eye, nasal and mouth protectionAdditional respiratory protection required(see facial protection section)Each HCW should make an risk assessment of the planned procedureand select PPE depending on;• The nature of the procedure• The risk of exposure to blood and body fluids• The risk of contaminationGloves Gloves should be single use items and should conform to EuropeanCommunity StandardsNo extra precautions recommendedGloves are recommended;• For all activities that carry a risk of exposure to blood, body fluids,secretions or excretions, sharps or contaminated instruments• When touching mucous membranes and non-intact skin• When handling contaminated equipmentGloves should be;• Single use only• Sterile if contact anticipated with sterile body site• Put on immediately before an episode of patient contact andremove as soon as the activity is completed• Changed when caring for different patients and between differentcare activities on the same patient• Disposed of as health care risk waste if contaminated with blood orbody fluids from patients with suspected or known infection.Hand hygiene should be performed before donning and immediatelyfollowing removal of glovesSTANDARD PRECAUTIONS AIRBORNE PRECAUTIONSFaceprotectionFace protection should be worn where:•There is a risk of blood, body fluids,secretions or excretions splashing into theface or eyesIn addition to eye protection as required for Standard PrecautionsHCWs and visitors should don correctly fitted:• FFP2 masks before entering the isolation room of a suspected or confirmedinfectious TB case where MDR-TB not suspected-177-
<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCClinicalWorkPracticeUse ofPersonalProtectiveEquipment(PPE)ClinicalWorkPracticeUse ofPersonalProtectiveFaceprotectionAprons orgownsbody fluids from patients with suspected or known infection.Hand hygiene should be performed before donning and immediatelyfollowing removal of glovesSTANDARD PRECAUTIONS AIRBORNE PRECAUTIONSFace protection should be worn where:In addition to eye protection as required for Standard Precautions••There is a risk of blood, body fluids,secretions or excretions splashing into theface or eyesWhen placing a catheter or injecting intothe spinal or epidural space.Face protection consists of one of thefollowing:••••Fluid repellent mask with separategogglesRespiratory mask (FFP2/3)Face shieldFluid repellent mask with eye shield.Face protection should be:•Single use or single person use (faceshields and goggles can be reusedby the same HCW but they must beadequately cleaned and disinfected asper manufacturer’s instructions after eachuse.HCWs and visitors should don correctly fitted:• FFP2 masks before entering the isolation room of a suspected or confirmedinfectious TB case where MDR-TB not suspected• FFP3 mask during high risk procedures for all patients where TB is suspectedor confirmed (susceptible or MDR) such as:o Sputum inductiono Cough producing procedures (e.g. administering aerosolisedmedications, bronchoscopy, airway suctioning, endotracheal intubation)o Procedures where aerosolisation of drainage fluid from an abscess/lesions may occur• FFP3 masks before entering the isolation room of a suspected or known caseof MDR-TB or XDR-TBTo preserve privacy and confidentiality restricting visiting to immediate familyshould be discussed with the patientAll HCWs who may be required to use respiratory masks (FFP2 & FFP3) duringthe course of their work should be fit tested by a trained professional within eachorganisationHCWs should fit check the mask each time it is worn to check the sealHCWs visiting a patient in their own home should wear a FFP2 or FFP3 mask whilethe patient is infectious (see chapter 6 on Infection Prevention and Control fordiscontinuation of Airborne Precautions). Patient privacy must be maintained ifmask is worn in the home.All masks should be removed in the ante room or immediately outside the singleroom if there is no ante roomDiscard mask into healthcare risk wasteDecontaminate hands immediately after removing maskSTANDARD PRECAUTIONS AIRBORNE PRECAUTIONSDisposable aprons should be worn where there is a risk that the front ofuniform/clothing may become exposed to blood, body fluids, excretionsor secretionsNo extra precautions recommended-178-
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Guidelines on the Prevention and Control of Tuberculosis in Ireland

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