PPE and Hand Washing Guidance

Updated 03/09/2020

1Copyright © 2020 - Northamptonshire County Council: NASS

PPE in care homes and day services Change gloves and apron between tasks or people. You may wear the same mask between residents or tasks so long as you do not take the mask off, or lower it from your face. You should not touch your face mask whilst wearing it. Once removed – dispose of PPE.

See Poster guides on how to safely put on and take off PPE as well as the Video on how to safely put on and take off PPE.

See guidance- page 15 for further information regarding shielding.

*please note that if you are not able to ensure that residents with symptoms are isolating within their own rooms then specialist advice should be sought from the infection prevention control team on nccg.communityipc.covid19@nhs.net

PPE for domiciliary care teamsIf a member of the household who is not being cared for has symptoms – they should remain outside the room or rooms where the care worker is working. If unable to maintain 2 metre distance from anyone who is coughing (including the client) then workers should follow the recommendations for clients who have symptoms.

• You must put your face mask on before entering a person’s home.

• You may wear the same mask between different homecare visits (or visiting different people living in an extra care scheme), so long as you do not take the mask off, or lower it from your face. You should not touch your face mask whilst wearing it. Once removed – dispose of PPE.

Change gloves and apron between tasks or people.

See guidance- page 15 for further information regarding shielding.

Recommended PPE• For those working in laundry in homes gloves, apron and a surgical mask must be worn, when handling/ dealing with

potentially contaminated items. Kitchen staff should wear PPE in line with their service specific risk assessments as well as a face mask.

• If within a residential home you are not able to ensure that residents with symptoms are isolating within their own rooms then specialist advice should be sought from the infection prevention control team: nccg.communityipc.covid19@nhs.net

• Please see full guidance for care homes here (day services should also follow this guidance): https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881329/COVID-19_How_to_work_safely_in_care_homes.pdf

• Please see full guidance for home care here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881296/Domiciliary_care_guidance_final.pdf

• Enhanced PPE is required for anyone conducting aerosol generating procedures – please see guidance for more details here: https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-aerosol-generating-procedures

Disposable Gloves and ApronsThese are single use only, to be worn when supporting with personal care or any time where there is a risk of close personal contact or contact with bodily fluids or an individual who has a virus/ infection.

Gloves and aprons must be changed when dirty/ contaminated and between tasks or individuals.

Gloves are NOT a substitute for hand washing hands must be thoroughly washed immediately after removal of each item of PPE.

Personal protective equipment

Eye/ Face Protection To be used where there is any risk of splashing/ contamination to the eyes or face for example when cleaning items used for collection of bodily fluids, when supporting someone with brushing their teeth or when caring for someone who is coughing (for example because they have COVID-19) or may be vomiting.

If you need to have physical contact with someone who has confirmed or symptoms of COVID you must wear eye protection.

If you are in doubt about whether there is a risk or not, eye/ face protection should be worn.

Do not touch the eye/ face protection whist you are wearing it.

Each team member must be allocated their own face shield or goggles which are wiped between uses and then washed with warm soapy water and left to air dry at the end of the shift, if this cannot be done the eye protection should be disposed of as clinical waste.

The face shield or goggles continue to be used by that same person until they become cracked or distorted at which point they should be disposed of as clinical waste.

The staff member must ensure the PPE is checked for damage prior to each use.

Eye/ Face Protection

Face Mask

• All staff working in residential homes and domiciliary care services, including those who do not have contact with people we support must wear a mask at all times in areas of the building that are shared by staff delivering direct support or customers (other than when taking a break e.g. to have something to eat or drink in a designated staff area)

• Masks are effective only when properly fitted and used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water

• Do not allow a face mask to dangle around you neck after or between each use

Face mask

• See table of recommended PPE for guidance on whether to wear a fluid resistant surgical mask or a surgical mask. When selecting the appropriate mask please pay attention to packaging to ensure you have the correct one as they may look similar.

Fluid resistant surgical masks can be identified as the box they are taken from will detail ‘fluid resistant type IIR’.

• Before putting on a mask, ensure you are hydrated, tie hair back, remove jewellery and clean hands with alcohol-based hand rub or soap and water.

• Put the mask on before going into someone's home in the community.

• Cover your mouth and nose with mask and make sure there are no gaps between your face and the mask. Press thin metal strip gently against the bridge of your nose and extend to cover your chin.

• Do not touch the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.

Face mask continued

• Masks can be used continuously while providing care, until you take a break from duties (e.g. to drink, eat, take a break from duties at your break time or at end of shift). So long as you do not take the mask off, or lower it from your face..

• Replace the mask with a new one as soon as it is damp, damaged or uncomfortable and do not re-use single-use masks.

• Remove outside the persons room, cohort area or 2 meters away from the person with possible/confirmed COVID-19

If someone you are supporting has symptoms of or confirmed coronavirus they should wear a face mask when in communal areas and on transport if possible.

PPE

If using PPE sessionally (Sessional use refers to using PPE for a period of time where you may be supporting more than one person)

• DO Make sure that it is comfortably put in place and will not need adjustment

• DO Take a comfort break before putting it on and remain well hydrated

• DO NOT take it off and leave it on surfaces

• DO NOT walk out with a mask hanging off your chin or with goggles on top of your head

Gloves and apron should never be used sessionally.

Hands should be washed to the elbow between patients. Gloves are not a substitute for hand hygiene.

Putting on PPEPPE should be put on before entering residents room in a res home

Mask should be put on before entering someone's own home

Click the link below to see this information on web page format

https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-non-aerosol-generating-procedures

Removing PPEWithin the room you are supporting the individual

• Remove gloves: Grasp the outside of the glove with the opposite gloved hand and peel off, hold that glove in the gloved hand, slide the un-gloved finger under the remaining glove at the wrist and peel off keeping the first removed glove inside. Dispose of as clinical waste.

• Wash your hands thoroughly -extending to forearms

• Remove apron: Unfasten or break ties at the back, pull apron away from your neck and lift over your head touching only the inside, fold or roll into a bundle (outside in) and dispose as clinical waste.

• Wash your hands thoroughly -extending to forearms

Leave the room of the individual you are supporting before removing eye protection and face mask.

Removing PPE• Eye protection: Remove by touching the headband or sides only (do not

touch the front). For reusable wipe between use and wash with warm soapy water at the end of your shift.

Dispose of as clinical waste if not reusable or you are unable to clean.

• Wash your hands thoroughly -extending to forearms

• Face mask: Untie or break bottom ties, followed by top ties or elastic, remove by handling the ties only. Lean forward slightly and close your eyes. Discard immediately as clinical waste (Never remove your mask and put it down on a surface- always dispose of immediately).

• Wash your hands thoroughly- extending to forearms

Click the below link to see this information in a webpage format:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/875212/Taking_off_PPE_for_non-aerosol_generating_procedures_quick_guide.pdf

Putting on and taking off PPEPlease follow the below link, you must watch the full video clip on how to put on and take off PPE

https://www.youtube.com/watch?v=-GncQ_ed-9w&feature=youtu.be

Building based services should have designated areas for putting on and taking off PPE, separate areas is preferable.

PPE

You will have a competency assessment completed by a senior team member to ensure you are able to wash hands and use PPE appropriately and inline with guidance.

It is recommended that you practice putting on and removing PPE.

If at any point you are not sure what PPE you should be wearing, how to use it, dispose of it or when to remove it you must seek advice from your manager or supervisor immediately.

How to hand wash

How to hand rub

If alcohol based hand sanitisers/ rubs are used, you must make sure all liquid is evaporated before touching any surfaces due to the risk of injury/burns.

Do not wear a stoned ring

Remember to wash and rinse under a plain wedding ring

Hand hygiene should be performed to the elbow.