5.3 Personal Protective Equipment (PPE) and Standard Precautions
Key Takeaways
- Standard Precautions apply to ALL residents regardless of diagnosis
- PPE donning order: Gown → Mask → Goggles → Gloves (last on)
- PPE doffing order: Gloves → Goggles → Gown → Mask → Hand Hygiene (gloves first off)
- Contact Precautions (MRSA, C. diff): gloves + gown for all contact
- Droplet Precautions (flu): surgical mask within 3-6 feet
- Airborne Precautions (TB): N95 respirator + negative pressure room
- Illinois IDPH requires outbreak reporting within 24 hours
Last updated: March 2026
Personal Protective Equipment (PPE) and Standard Precautions
Standard Precautions are the baseline infection control practices used for ALL residents, regardless of their diagnosis. They are based on the principle that all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents.
Standard Precautions Components
| Component | Application |
|---|---|
| Hand Hygiene | Before and after all patient contact and procedures |
| PPE | Gloves, gowns, masks, eye protection as needed |
| Respiratory Hygiene | Cover coughs/sneezes, wear masks when indicated |
| Safe Injection Practices | Use new needle/syringe for each injection (nurse responsibility) |
| Sharps Safety | Do not recap needles; dispose in sharps containers |
| Environmental Cleaning | Regular cleaning and disinfection of surfaces |
| Linen Handling | Handle soiled linen with minimal agitation |
| Patient Care Equipment | Clean and disinfect between residents |
Personal Protective Equipment (PPE) Types
| PPE | When to Use | Proper Use |
|---|---|---|
| Gloves | Any contact with blood, body fluids, mucous membranes, non-intact skin | Change between tasks; change between residents; remove before touching clean surfaces |
| Gown | Anticipated contact with body fluids or soiled materials; contact precautions | Tie at neck and waist; covers arms and torso; remove before leaving room |
| Surgical Mask | Droplet precautions; within 3-6 feet of coughing resident | Cover nose and mouth; mold nose piece; replace when damp |
| N95 Respirator | Airborne precautions (TB, measles) | Must be fit-tested; form-seal around nose and mouth |
| Eye Protection (Goggles/Shield) | Anticipated splash or spray of body fluids | Cover eyes completely; clean and disinfect after use |
Order of PPE Application (Donning)
Put PPE on in this order before entering the room:
- Gown — Open and tie at neck, then waist
- Mask/Respirator — Place over nose and mouth, secure
- Goggles/Face Shield — Place over face and adjust
- Gloves — Put on last; extend over gown cuffs
Order of PPE Removal (Doffing)
Remove PPE in this order to prevent self-contamination:
- Gloves — Peel off from wrist; do not snap; dispose in trash
- Goggles/Face Shield — Remove by headband or earpieces (do not touch front)
- Gown — Untie; pull away from body; roll inside out; dispose
- Mask/Respirator — Remove by ear loops or ties (do not touch front); dispose
- Hand Hygiene — Wash hands or use hand sanitizer immediately after removing all PPE
Transmission-Based Precautions
When Standard Precautions are not sufficient, additional transmission-based precautions are added:
| Precaution Type | Used For | Additional PPE/Actions |
|---|---|---|
| Contact Precautions | MRSA, C. diff, scabies, wound infections | Gloves + gown for all contact; dedicated equipment; private room preferred |
| Droplet Precautions | Influenza, pertussis, meningitis | Surgical mask within 3-6 feet; private room; limit transport |
| Airborne Precautions | Tuberculosis, measles, chickenpox | N95 respirator; negative pressure room; door closed at all times |
Illinois IDPH Infection Control Requirements
Illinois facilities must comply with IDPH regulations that include:
- Antibiotic Stewardship Programs — Reducing unnecessary antibiotic use
- Infection Surveillance — Tracking and reporting infection rates
- Staff Vaccination Programs — Annual influenza vaccination offered to all staff
- TB Screening — Baseline TB screening for all new employees, with annual risk assessment
- Hand Hygiene Monitoring — Regular compliance audits
- Outbreak Reporting — Facilities must report outbreaks to IDPH within 24 hours
- COVID-19 Protocols — Testing, vaccination, and PPE requirements as directed by IDPH
Test Your Knowledge
When removing PPE, which item should be removed FIRST?
A
B
C
D
Test Your Knowledge
Standard Precautions should be used with:
A
B
C
D
Test Your Knowledge
A resident is on Contact Precautions for MRSA. What PPE must you wear for all contact with this resident?
A
B
C
D