Personal Protective Equipment

Objective:

Raise awareness of the role of PPE in reducing the spread of infection, when it should be worn, and how to safely put on (don) and remove (doff) it to minimise contamination risk.

Further information: Preventing Infection Workbook - Page 15

Why PPE Matters

PPE acts as a barrier to droplet transmission, protecting both staff and residents from infections such as COVID-19, influenza, and other respiratory or contact-spread illnesses. Correct use, including donning and doffing, is essential to prevent cross-contamination.

When to Use PPE

The level and type of PPE worn should be based on risk assessment and latest Welsh Government guidance and should be reviewed in event of identification of any infection within the care home setting. Links to the latest guidance can be found in the introduction section of this handbook.

Single use gloves and a single use disposable apron should be worn if contact with blood and/or other bodily fluids, non-intact skin or mucous membranes is anticipated or likely; or the resident has a confirmed or suspected infection.

When to wear gloves

Blood
Body fluids
Non-intact skin or mucous membranes
Suspected or confirmed infection

When not to wear gloves

Mobilising residents
Serving or assisting with food/drink
Providing comfort
Medication rounds

Gloves are NOT a substitute for good hand hygiene. Do not use alcohol gel on gloves or double glove.

Masks (Type IIR FRSM) — Wear when:

- There is a risk of respiratory infection (e.g., COVID-19, flu).
- Splashing of blood/body fluids to nose or mouth is possible i.e. risk of aerosol or droplet transmission.

Eye Protection (Safety Goggles or Visor) — Wear when:

- Risk of aerosol or droplet transmission to the eyes.
- Splashing of blood/body fluids likely.
- Ideally, disposable eye protection to be provided. Reuseable eye protection should be decontaminated after each use.

Key Rules for PPE Use

Single-use items (gloves, aprons, masks) must be changed between residents.
Hand hygiene before putting on PPE, between items during removal, and after all PPE is removed.
Do not use alcohol gel on gloves.
Do not double glove.

Correct order for putting on and taking off PPE

Also see the UK Health Security Agency poster 'Guide to donning and doffing PPE' in the Resources Section below. This can be displayed in relevant locations within care home settings.

Putting PPE On (Donning)

Step 1: Perform hand hygiene

Step 2: Put on plastic apron (tie securely)

Step 3: Put on surgical mask (tie securely)

Step 4: Put on eye protection (if risk identified)

Step 5: Put on non-sterile gloves

Taking PPE Off (Doffing)

Step 1: Remove gloves → perform hand hygiene

Step 2: Remove apron (fold inwards, avoid touching outer surface). Dispose of in clinical waste

Step 3: Remove eye protection outside the resident's room → perform hand hygiene

Step 4: Remove mask by straps (bottom first), avoiding contact with the front. Dispose of safely

Step 5: Wash hands thoroughly with soap and water

Safe Use of Surgical Masks (FRSM)

Wear for a full session (e.g., drug round, ward round) unless damp, damaged, or contaminated.
Never:
- Pull under chin or nose.
- Let it hang from one ear.
Do not touch the front of the mask, if you do, wash/gel your hands immediately.
If a colleague touches their mask, politely prompt them to wash/gel their hands.

Resources
Correct order for putting on and removing: Correct-order-for-putting-on-and-removing-PPE-May-2025.pdf
UKHSA Donning & Doffing PPE Poster - Guide to donning and doffing PPE: Guide to donning and doffing PPE: Droplet Precautions
PPE Audit Tool (for induction, monthly audits, or incident response) PPE Audit Tool
IPC Glove Selection Guide: Glove-selection-guide-Care-Homes-March-2024.pdf
NHS Donning/Doffing Video: Infection prevention control guidance to staff - Donning and Doffing - YouTube