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Personal Protective Equipment Subpart I

Personal Protective Equipment Subpart I. Occupational Safety and Health Course for Healthcare Professionals. Objectives. Identify the general requirements for personal protective equipment. Describe the requirements for eye, respiratory, hand, head, and foot protection.

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Personal Protective Equipment Subpart I

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  1. Personal Protective EquipmentSubpart I Occupational Safety and Health Course for Healthcare Professionals

  2. Objectives • Identify the general requirements for personal protective equipment. • Describe the requirements for eye, respiratory, hand, head, and foot protection. • Discuss the implications of these requirements for healthcare settings.

  3. Personal Protective Equipment Definition “Specialized clothing or equipment, worn by an employee for protection against infectious or other hazardous materials/objects.

  4. General Requirements – 1910.132-.138 • PPE for eyes, face, hand, extremities, protective clothing, respiratory devices, protective shields and barriers: * Shall be provided, used, and maintained in a sanitary and reliable condition, * Wherever it is necessary by reason of hazards or processes or environment.

  5. Employer Responsibilities • Must provide PPE at no cost to employee. • Must assess all work environments for potential hazards. • Must provide training to any employee who uses any PPE. • Must pay for replacement of any required PPE, unless the employee has lost or intentionally damaged the item.

  6. Hazards that may require PPE • Chemical • Radiological • Thermal • Mechanical • Blood and OPIM (other potential infectious material) Encountered by an employee in a manner capable of causing injury or impairment in any function/body part through absorption, inhalation, or physical contact.

  7. Hazard Assessment • Employer shall assess the workplace to determine if hazards are present that require the use of PPE. • Communicate presence of hazards to employees. • Select the appropriate PPE – must fit each employee.

  8. Hazard Assessment in Healthcare • Engage supervisors and employees in the process. • Assess in all work locations: support service areas, patient care areas, specialty areas, facility management areas, external areas, etc. • Need to have a written certification that identifies what was evaluated, who did it, the date. • Reassess when appropriate - if services change, locations change.

  9. Eye and Face Protection • Locations/situations in healthcare where this is needed? • Must ensure that each affected employee uses eye protection that provides front and side protection from flying objects/materials. • If they wear prescription lenses, the eye protection can incorporate the prescription in the design, or be worn over the prescription lenses – must not disturb the prescription lenses or the protective lenses.

  10. Challenges with eye protection in health care • Does everyone who should wear this, do so, every time? • Are they fit properly? • Are they checked to be sure they are in good condition? • What could we do differently?

  11. Respiratory Protection • First Priority: Engineering Controls. • Includes: enclosure or confinement, general or local ventilation, or substitution of less toxic materials. • When engineering controls are not adequate or feasible: Face masks or Respirators should be used!

  12. Masks and Respirators • Provided by the employer. • Must be applicable and suitable for the purpose and potential hazards involved. • Must establish and maintain a respiratory protection program.

  13. Important Points • Identify when and where respiratory PPE needs to be used by employees and what type. • Provide Medical evaluations prior to fit-testing and use. • Follow standards on fit-testing procedure. • Documentation requirements! • N95 or higher NIOSH certified respirators.

  14. Hand Protection • Employer must select and provide appropriate hand protection for employees that are exposed to hazards: * skin absorption of harmful substances * severe cuts, lacerations, or abrasions * punctures * chemical or thermal burns * harmful temperature extremes

  15. Gloves • When and where: patient care, environmental services, engineering, laboratory, other areas. • Glove material: vinyl, latex, nitrile, other. • Sterile and nonsterile. • Single use or reusable. • Critical to train employees on appropriate use, putting on, and taking off of gloves.

  16. Head Protection • For employees working in areas where there is a potential for injury to the head from falling objects. • When would this apply in healthcare settings?

  17. Foot Protection • Employees use protective footwear when working in areas where there is: * danger of foot injuries due to falling or rolling objects; * objects that can pierce the sole; * where employee’s feet are exposed to electrical hazards.

  18. In Healthcare? • Not too often do we encounter such hazards. • Be aware – particularly if there is construction, reconstruction going on in the work setting. • CFR 1910.132 (h)(1-6) – specifies when the employer does and does not have to pay for protective equipment.

  19. Sequence for Putting on PPE • Gown first • Mask or respirator • Goggles or face shield • Gloves • Combination of PPE will affect sequence – be practical !

  20. How to Don a Particulate Respirator • Select a fit tested respirator • Place over nose, mouth and chin • Fit flexible nose piece over nose bridge • Secure on head with elastic • Adjust to fit • Perform a fit check – • Inhale – respirator should collapse • Exhale – check for leakage around face

  21. Sequence for Removing PPE • Gloves • Face Shield or goggles • Gown • Mask or respirator • And always wash hands thoroughly after removal of PPE!

  22. Employee Education • Must train before they use the PPE. • Need to know at least the following: * when PPE is necessary * what PPE is necessary * How to properly put on, take off, adjust, and wear PPE * the limitations of the PPE * proper care, maintenance, useful life, and disposal of PPE. Resources available: OSHA and CDC/NIOSH

  23. Employee Education • Before using any PPE. • Document training. • Do not make assumptions about prior knowledge of the use of PPE!

  24. In Healthcare? • When do you want employees to use hand protection? • What are some of the most important “engineering controls” we need to provide? • Gloves/all PPE must be easily accessible, in good condition, good fit for every employee. • Monitoring practices. • Current state of our art?

  25. How could we improve appropriate use of PPE? • Monitoring • Reminders – examples? • Easy access • Good role models/teachers

  26. Enhanced focus: OSHA standards on Bloodborne Pathogens • Hazard in healthcare and first responder situations. • Must control contact with blood and OPIM. • Provide hand, eye, face, full body protection – easily accessible and good fit. • Teach employees how to use, when to use, how to put on and take off, how to dispose.

  27. Just a Reminder: Goal of PPE Use • To improve employee safety. • To enhance our care of patients, keeping them and their families safe.

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