美国CDC医疗机构内个人防护用品(PPE)选择和使用指南(英文版)PPT课件.ppt

GuidancefortheSelectionandUseofPersonalProtectiveEquipment PPE inHealthcareSettings PPEUseinHealthcareSettings ProgramGoal ImprovepersonnelsafetyinthehealthcareenvironmentthroughappropriateuseofPPE PPEUseinHealthcareSettings PPEUseinHealthcareSettings ProgramObjectives ProvideinformationontheselectionanduseofPPEinhealthcaresettingsPracticehowtosafelydonandremovePPE PPEUseinHealthcareSettings PersonalProtectiveEquipmentDefinition specializedclothingorequipmentwornbyanemployeeforprotectionagainstinfectiousmaterials OSHA PPEUseinHealthcareSettings RegulationsandRecommendationsforPPE OSHAissuesworkplacehealthandsafetyregulations RegardingPPE employersmust ProvideappropriatePPEforemployeesEnsurethatPPEisdisposedorreusablePPEiscleaned laundered repairedandstoredafteruseOSHAalsospecifiescircumstancesforwhichPPEisindicatedCDCrecommendswhen whatandhowtousePPE PPEUseinHealthcareSettings HierarchyofSafetyandHealthControls TrainingandadministrativecontrolsEngineeringcontrolsWorkpracticecontrolsPersonalprotectiveequipment PPEUseinHealthcareSettings TypesofPPEUsedinHealthcareSettings Gloves protecthandsGowns aprons protectskinand orclothingMasksandrespirators protectmouth noseRespirators protectrespiratorytractfromairborneinfectiousagentsGoggles protecteyesFaceshields protectface mouth nose andeyes PPEUseinHealthcareSettings FactorsInfluencingPPESelection TypeofexposureanticipatedSplash sprayversustouchCategoryofisolationprecautionsDurabilityandappropriatenessforthetaskFit PPEUseinHealthcareSettings Gloves Purpose patientcare environmentalservices otherGlovematerial vinyl latex nitrile otherSterileornonsterileOneortwopairSingleuseorreusable PPEUseinHealthcareSettings Gloves Purpose patientcare environmentalservices otherGlovematerial vinyl latex nitrile otherSterileornon sterileOneortwopairSingleuseorreusable PPEUseinHealthcareSettings Do sandDon tsofGloveUse Workfrom cleantodirty Limitopportunitiesfor touchcontamination protectyourself others andtheenvironmentDon ttouchyourfaceoradjustPPEwithcontaminatedglovesDon ttouchenvironmentalsurfacesexceptasnecessaryduringpatientcare PPEUseinHealthcareSettings Do sandDon tsofGloveUse cont d ChangeglovesDuringuseiftornandwhenheavilysoiled evenduringuseonthesamepatient AfteruseoneachpatientDiscardinappropriatereceptacleNeverwashorreusedisposablegloves PPEUseinHealthcareSettings GownsorAprons PurposeofuseMaterial Naturalorman madeReusableordisposableResistancetofluidpenetrationCleanorsterile PPEUseinHealthcareSettings FaceProtection Masks protectnoseandmouthShouldfullycovernoseandmouthandpreventfluidpenetrationGoggles protecteyesShouldfitsnugglyoverandaroundeyesPersonalglassesnotasubstituteforgogglesAntifogfeatureimprovesclarity PPEUseinHealthcareSettings FaceProtection Faceshields protectface nose mouth andeyesShouldcoverforehead extendbelowchinandwraparoundsideofface PPEUseinHealthcareSettings RespiratoryProtection Purpose protectfrominhalationofinfectiousaerosols e g Mycobacteriumtuberculosis PPEtypesforrespiratoryprotectionParticulaterespiratorsHalf orfull faceelastomericrespiratorsPoweredairpurifyingrespirators PAPR PPEUseinHealthcareSettings ElementsofaRespiratoryProtectionProgram MedicalevaluationFittestingTrainingFitcheckingbeforeuse PPEUseinHealthcareSettings Foradditionalinformationonrespirators http www cdc gov niosh npptl respirators respsars htmlhttp www cdc gov niosh 99 143 htmlhttp www cdc gov niosh topics respirators PPEUseinHealthcareSettings PPEUseinHealthcareSettings HowtoSafelyDon Use andRemovePPE KeyPointsAboutPPE Donbeforecontactwiththepatient generallybeforeenteringtheroomUsecarefully don tspreadcontaminationRemoveanddiscardcarefully eitheratthedoorwayorimmediatelyoutsidepatientroom removerespiratoroutsideroomImmediatelyperformhandhygiene PPEUseinHealthcareSettings Sequence forDonningPPE GownfirstMaskorrespiratorGogglesorfaceshieldGloves CombinationofPPEwillaffectsequence bepractical PPEUseinHealthcareSettings HowtoDonaGown SelectappropriatetypeandsizeOpeningisinthebackSecureatneckandwaistIfgownistoosmall usetwogownsGown 1tiesinfrontGown 2tiesinback PPEUseinHealthcareSettings HowtoDonaMask Placeovernose mouthandchinFitflexiblenosepieceovernosebridgeSecureonheadwithtiesorelasticAdjusttofit PPEUseinHealthcareSettings HowtoDonaParticulateRespirator SelectafittestedrespiratorPlaceovernose mouthandchinFitflexiblenosepieceovernosebridgeSecureonheadwithelasticAdjusttofitPerformafitcheck Inhale respiratorshouldcollapseExhale checkforleakagearoundface PPEUseinHealthcareSettings HowtoDonEyeandFaceProtection PositiongogglesovereyesandsecuretotheheadusingtheearpiecesorheadbandPositionfaceshieldoverfaceandsecureonbrowwithheadbandAdjusttofitcomfortably PPEUseinHealthcareSettings HowtoDonGloves DongloveslastSelectcorrecttypeandsizeInserthandsintoglovesExtendglovesoverisolationgowncuffs PPEUseinHealthcareSettings HowtoSafelyUsePPE KeepglovedhandsawayfromfaceAvoidtouchingoradjustingotherPPERemoveglovesiftheybecometorn performhandhygienebeforedonningnewglovesLimitsurfacesanditemstouched PPEUseinHealthcareSettings PPEUseinHealthcareSettings HowtoSafelyRemovePPE Contaminated and Clean AreasofPPE Contaminated outsidefrontAreasofPPEthathaveorarelikelytohavebeenincontactwithbodysites materials orenvironmentalsurfaceswheretheinfectiousorganismmayresideClean inside outsideback tiesonheadandbackAreasofPPEthatarenotlikelytohavebeenincontactwiththeinfectiousorganism PPEUseinHealthcareSettings SequenceforRemovingPPE GlovesFaceshieldorgogglesGownMaskorrespirator PPEUseinHealthcareSettings WheretoRemovePPE Atdoorway beforeleavingpatientroomorinanteroom Removerespiratoroutsideroom afterdoorhasbeenclosed Ensurethathandhygienefacilitiesareavailableatthepointneeded e g sinkoralcohol basedhandrub PPEUseinHealthcareSettings HowtoRemoveGloves 1 GraspoutsideedgenearwristPeelawayfromhand turninggloveinside outHoldinoppositeglovedhand PPEUseinHealthcareSettings HowtoRemoveGloves 2 SlideunglovedfingerunderthewristoftheremainingglovePeelofffrominside creatingabagforbothglovesDiscard PPEUseinHealthcareSettings RemoveGogglesorFaceShield GraspearorheadpieceswithunglovedhandsLiftawayfromfacePlaceindesignatedreceptacleforreprocessingordisposal PPEUseinHealthcareSettings RemovingIsolationGown UnfastentiesPeelgownawayfromneckandshoulderTurncontaminatedoutsidetowardtheinsideFoldorrollintoabundleDiscard PPEUseinHealthcareSettings RemovingaMask Untiethebottom thentop tieRemovefromfaceDiscard PPEUseinHealthcareSettings RemovingaParticulateRespirator LiftthebottomelasticoveryourheadfirstThenliftoffthetopelasticDiscard PPEUseinHealthcareSettings HandHygiene PerformhandhygieneimmediatelyafterremovingPPE IfhandsbecomevisiblycontaminatedduringPPEremoval washhandsbeforecontinuingtoremovePPEWashhandswithsoapandwateroruseanalcohol basedhandrub PPEUseinHealthcareSettings Ensurethathandhygienefacilitiesareavailableatthepointneeded e g sinkoralcohol basedhandrub PPEUseinHealthcareSettings WhentoUsePPE StandardandExpandedIsolationPrecautions StandardPrecautions PreviouslycalledUniversalPrecautionsAssumesbloodandbodyfluidofANYpatientcouldbeinfectiousRecommendsPPEandotherinfectioncontrolpracticestopreventtransmissioninanyhealthcaresettingDecisionsaboutPPEusedeterminedbytypeofclinicalinteractionwithpatient PPEUseinHealthcareSettings PPEforStandardPrecautions 1 Gloves Usewhentouchingblood bodyfluids secretions excretions contaminateditems fortouchingmucusmembranesandnonintactskinGowns Useduringproceduresandpatientcareactivitieswhencontactofclothing exposedskinwithblood bodyfluids secretions orexcretionsisanticipated PPEUseinHealthcareSettings PPEforStandardPrecautions 2 Maskandgogglesorafaceshield Useduringpatientcareactivitieslikelytogeneratesplashesorspraysofblood bodyfluids secretions orexcretions PPEUseinHealthcareSettings WhatTypeofPPEWouldYouWear PPEUseinHealthcareSettings WhatTypeofPPEWouldYouWear PPEUseinHealthcareSettings PPEforExpandedPrecautions Expan