HANDS-ON SAFETY: Jessica Cotter, a clinical research coordinator, demonstrates pulling a glove securelyover the cuff of a gown.
STAFF, PATIENTS AND VISITORS ALIKE may be familiar with the yellow signs posted on the doors of patient rooms that indicate special precautions are needed to prevent the spread of infection. The need for special precautions is based on how a specific germ may spread, and the sign posted at the entrance to the patient’s room describes the additional steps required for staff members working with the patient.
The two most common types of precautions, Contact Precautions and Contact Precautions Plus, are used when there is a risk of spreading certain germs by touching or physically coming in contact with the patient or with items and surfaces in the patient’s room. This contact can result in germs being picked up on hands and clothing; germs can then be carried to the next patient or to a surface in another patient’s room. Contact Precautions Plus is used for germs capable of producing spores, which can survive on surfaces for long periods of time.
“Because germs can be spread by contaminated hands or clothing, staff members are always required to wear gloves when entering a Contact Precautions or Contact Precautions Plus room,” says Paula Wright, RN, director of the Infection Control Unit. “A gown must also be worn if the employee’s body or clothes may come into contact with the patient, items or surfaces in the patient’s room.”
Wright adds that gloves are required to enter a Contact Precautions or Contact Precautions Plus room – even if only for a moment – because inadvertent contact may occur. Although using gloves and gowns at appropriate times may seem simple enough, there is a right and wrong way to wear protective equipment. The following is a reminder about proper usage:
1. Before putting on gloves or gowns, always use hand hygiene.
2. Put on the gown with the opening at the back. Tie it at the neck to ensure it covers clothing completely and stays securely in place.
3. Put on the gloves, and pull them over the cuffs of the gown to prevent wrist exposure. It is now OK to enter the room.
4. When leaving the room, gloves are removed first. Pull one glove off, avoiding contact between the glove and skin and gathering it into the hand that is still gloved. Slip a bare finger inside the wrist of the remaining glove and slide it off so that it is inside-out over the first glove. Discard the gloves immediately.
5. To remove the gown, untie it and pull it forward, away from the body and clothing. Holding the gown away from the body, fold or roll it into a bundle so that the contaminated side faces inward, and place it in a linen hamper. Do not save gowns for reuse.
6. Use hand hygiene immediately after removing gloves and gown. When leaving a Contact Precautions room, disinfect hands with Cal Stat. When leaving a Contact Precautions Plus room, wash and dry hands first to remove spores and then disinfect with Cal Stat.
Wright notes that visitors should use hand hygiene before and after visiting a patient’s room and although visitors are not required to wear gloves or gowns when visiting a patient on precautions, they are encouraged to do so, especially if assisting with the patient’s care or visiting more than one patient.
For more information about personal protective equipment, call 617-726-2036. For more information about other Excellence Every Day topics, access http://intranet.massgeneral.org/excellenceeveryday.
Read more articles from the 4/13/12 Hotline issue.