Protect Against Bloodborne Pathogens: The Proper Way To Put on PPE

Nurse putting on gloves

The Centers for Disease Control and Prevention (CDC) estimates that 5.6 million workers in healthcare are exposed to bloodborne pathogens every year. Wearing personal protective equipment (PPE) is the most effective way to stop the spread of bloodborne pathogens in any healthcare facility.

While there isn't one correct way of putting on PPE, the CDC and the Occupational Safety and Health Administration (OSHA) have outlined the importance of using PPE when exposed to blood and other bodily fluids. 

Improper usage of PPE raises the risk of infection for healthcare professionals. Staying up to date on the latest equipment and procedures is necessary to save lives and keep health workers safe. Keep reading the article to learn the proper way to don PPE when working with bloodborne pathogens. 

What are Bloodborne Pathogens?

OSHA defines bloodborne pathogens (BBP) as pathogenic microorganisms present in human blood that can cause disease in humans. You can find this definition under OSHA standard 29 CFR 1920.1030. 

Despite the name, blood, saliva, semen, vaginal secretions, and other bodily fluids can transmit these pathogens.

Transmission of bloodborne pathogens most commonly occurs through open wounds, such as small cuts. However, it can also happen through abrasions, bites, mucous membranes, needle sticks, and sexual activity.

Examples of well-known bloodborne pathogens are Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV). 

Bloodborne Pathogens Training

All healthcare professionals who work with and around patients should receive specific training on bloodborne pathogens. Even volunteers need the training to understand the responsibilities involved in dealing with bloodborne pathogens. 

Of course, the training teaches how to handle these pathogens. It includes how they spread and how to protect against the spread using PPE. The training teaches step-by-step how to don PPE. In addition, healthcare workers learn what PPE to use depending on their level of exposure to a pathogen.

The training also teaches how to comply with different laws. For example, OSHA standard 1920.1030 has its own set of compliance. They are universal precautions (UP), standard precautions (SP), and transmission-based precautions (TBP).

Universal precautions came about in the 1980s. They treat all human blood and bodily fluids as infections. Standard precautions were introduced in 1996 and include hand hygiene, PPE use, safe injection practices, safe management of contaminated materials, and more.

Transmission-based precautions add an extra layer of protection not covered by SPs to control the transmission of a patient's infection. In addition, they give doctors access to more patient placement and isolation options and extra pieces of PPE like surgical caps and shoe coverings.

The CDC also has recommended guidelines to follow, and each healthcare facility will have its own set of practices. However, healthcare workers must comply with all guidelines laid out.

Employees also learn about exposure control plans and post-exposure steps in bloodborne pathogen training' these act to keep the environment as safe and pathogen-free as possible.

Let's Talk PPE

Several pieces of PPE are available for healthcare workers. These include:

  • Aprons
  • Disposable gloves
  • Eye goggles
  • Face masks
  • Full face shields 
  • Gowns
  • Lab coats
  • Mouthpieces for resuscitation 
  • Protective apparel
  • Respirators
  • Safety glasses with side shields

Specific bloodborne pathogen kits are also available for workers going out of the healthcare facility. Workers fill them with various protective items for different situations.

Healthcare employees don't always need to don a full set of protective gear. The levels of exposure to bloodborne pathogens depend on the care the patient is receiving. Based on the treatment or procedure, healthcare professionals will require different levels of protection. 

For example, if a lab technician draws blood on a patient, disposable gloves will be sufficient to prevent accidental transmission. However, if needles and other sharp objects are being used where blood may spray or splatter, more bloodborne pathogens PPE is necessary.

Your role in the healthcare facility will also determine how much PPE you need. For instance, front-office workers and janitors may need less protection depending on their interaction with infected patients. On the other hand, a nurse or doctor dealing directly with patients will need more protection.

As mentioned, you don't always need to wear a full PPE suit when working with bloodborne pathogens. But when you do need to suit up, you must follow each step to ensure no transmission is possible. 

Putting on a Full PPE Suit 

The first thing you need to do is choose the correct gown size. You should already know your size from previous training. In addition, collect all the other PPE you will need to put on. 

Next, you must sanitize your hands with hand sanitizer. After sanitizing, put on the isolation gown. Then, tie all of the ties. If you need assistance tying the ties, ask another healthcare worker to help you.

Once the gown is on securely, you need to put on your face respirator or face mask. You need to fit the respirator nosepiece to your nose with both hands to ensure it is not bent. Do not use one hand.

Whether you are using a respirator or face mask, it needs to cover both your mouth and nose. It should also extend under your chin. Finally, you should place the straps on the crown of your head and the base of your neck.

Next, perform a user seal check to make sure everything is in place. After the seal check, you put on your face shield or goggles. Depending on the respirator model or mask you are using, you need to choose eye protection that will not interfere with the correct positioning. Even the smallest of leaks in your respirator or mask can be harmful.Secure the Gloves 

The last step is to put on the gloves. The gloves are the most difficult and most important step. This is because the glove-gown interface is one of the weakest areas. It's where gaps easily occur. 

Especially as your hands and wrist move a lot while working, leakage is more likely between the end of the gown and the top of the glove. Therefore, you must securely place the gloves over the end of the gown from the wrist on.

Unfortunately, there is not enough research to give proper guidance on how to prevent gaps. Healthcare experts agree that a standardized method needs to be developed to improve protection in the future. 

Usually, the gown and gloves will come from different manufacturers. This means the fit will be imperfect hence why it is of the utmost importance to secure the gloves over the gown before seeing a patient.

Removing PPE

The removal of PPE is as important as putting it on. Contagious bodily fluids will be present on the garments after being with a patient. Some fluids are not seen by the naked eye, so proper removal is also essential. 

If blood or other bodily fluids penetrate a piece of PPE during a procedure, you must remove it immediately or as soon as possible. Even if bodily fluids didn't penetrate the PPE, you also need to dispose of damaged, cracked, and worn materials.

When finished with a patient, begin removal by gently taking off your gloves. Be sure to not cause contamination by using the glove-in-glove or bird-beak technique.

Then, remove the gown. Avoid any forceful movements. From the shoulders, pull the gown down and away from your body. You can roll it down if you choose. Once the gown is off, place it in the correct area or container. 

After the gown is away, sanitize your hands. Then, remove your face shield or goggles using the straps, pulling away from your face. Then remove the respirator or face mask.

Do not touch the front of these pieces of equipment. This is to protect your face from any cross-contamination with the equipment. Once you remove all the PPE, you must thoroughly sanitize your hands again.

Cleaning and Disposing of PPE

A lot of PPE is single-use. When you take off PPE, it needs to go into the correct trash container for hazardous materials. The containers must be leak-proof and not contain any needles or sharp objects that could cause a threat.

If the PPE is going to be used again, someone needs to be responsible for cleaning it as soon as possible using approved disinfectants and cleaners. Workers should not use aerosols and sprays in the cleaning process. They can create droplets in the air, causing further infection and disease.

Those cleaning the PPE should wear gloves and use tongs or other devices to avoid direct contact with the equipment.