Gowns and Goggles: Breaking Down the PPE Hospital Staff Wear to Prevent Infections
- Cassandra Derrick
- 11 minutes ago
- 4 min read
Introduction:
If you have visited someone in the hospital or have watched a medical drama, you may be
familiar with the gowns, masks, or goggles healthcare staff wear. You may have also worn a
mask during a visit to a hospital or clinic. These items represent personal protective equipment (PPE) that staff wear to protect themselves, patients, and visitors from healthcare associated infections. Healthcare associated infections (HAI), also known as healthcare acquired infections or nosocomial infections, are infections patients develop during or soon after a clinical visit, stay, or treatment. They can occur at any clinical location, like hospitals, outpatient offices, nursing homes, or long term care facilities (1, 2). It is estimated that 1 in 10 patients will develop an HAI. This number may be higher in low or middle income countries (3). HAIs are the most common adverse clinical event and are associated with increased healthcare costs, longer hospital stays, and complications like sepsis. Additionally, most HAIs are caused by antimicrobial resistant organisms, which can be difficult to manage because the typical drugs used to treat them are no longer effective (1,2). Hand hygiene and infection control protocols are important steps to reducing the burden of HAIs.
Types of HAIs and the pathogens that cause them:
HAIs are often grouped together based on the location of infection or the pathogen, which is a germ, causing the infection. Common HAIs include catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), surgical site infections (SSI), ventilator-associated pneumonia (VAP), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile (C. diff). Gram negative bacteria and hepatitis are also common pathogens that cause HAIs (1, 2).
Personal Protective Equipment (PPE):
PPE are items worn by healthcare staff, volunteers, and family members to physically protect
their clothes, skin, mouth, and eyes from pathogens. There are several types of PPE such as
gloves, head coverings, gowns, masks, respirators, goggles, and face shields. Each item must be carefully put on, taken off, and thrown away appropriately to prevent the spread of pathogens (1, 4).
The PPE chosen may be based on the symptoms a patient has, such as coughing, what
infection they have, or any potential exposures during patient care. Standard and transmission based precautions are categories that help healthcare staff keep track of which PPE to use. Commonly, signs are placed outside of patient care rooms that show healthcare staff and visitors what items to put on and how to dispose of them correctly after use (1, 4).
Standard precautions:
Standard precautions are used for all patients, in all healthcare settings. These precautions are used if blood, body fluids, mucous membranes, or any broken skin is present or may be present during patient care. In terms of PPE, gloves and masks are most often worn as part of standard based precautions, but gowns and eye protection may also be included if there is coughing or potential for contact with body fluids (1, 4).
Transmission based precautions:
While standard precautions are used for all patients, transmission based precautions are used in certain cases. Transmission based precautions are also referred to as isolation precautions because they are used when patients are infected or suspected to be infected by certain pathogens due to their symptoms. They are further divided into three types: contact, droplet, and airborne. In some cases, multiple types will be used to ensure the best protection (1, 4).
Contact precautions:
Contact precautions help prevent pathogens spread by contact
transmission, which means pathogens are spread by direct contact, like skin-to-skin touching, or indirect contact, like touching contaminated clothing. Since contact transmission is one of the most common causes of HAIs, contact precautions are also one of the most common precautions used in healthcare settings (1, 4).
Contact precautions are used if patients have severe diarrhea, a wound that is draining, or if
infected with a multidrug resistant organism. When possible, these patients are put in their own private room. Additionally, healthcare staff will wear gloves and gowns when interacting with a patient on contact precautions (1, 4). Droplet precautions: Droplet precautions help prevent pathogens spread by respiratory droplets, which are tiny drops of liquid that enter the air when someone talks, coughs, or sneezes.
Fortunately, these droplets do not travel far, only about three to six feet. However, droplets may also be spread by a person’s hands if they cough into them (1, 4).
Droplet precautions are used to prevent the spread of COVID, whooping cough, pneumonia, the flu, and other pathogens. They are also used for patients who are coughing or sneezing. Like contact precautions, these patients should be placed in their own room. Masks are the main form of PPE used for droplet precautions, but gowns and goggles are often also used (1, 4).
Airborne precautions:
Airborne precautions help prevent pathogens spread by aerosolized
particles, which are super tiny particles from the lungs that can hang suspended in the air or
travel long distances when talking, sneezing, or coughing (1, 4).
Airborne precautions are used to prevent the spread of COVID, measles, chickenpox,
tuberculosis, and other pathogens. These patients should be placed in a special isolation room that creates negative pressure so the air does not enter the hallway and is pumped outside, away from entrances into the hospital. They also require respirators or N-95s to be used rather than regular masks. Generally, gowns and eye protection are used if a patient is also on droplet or contact precautions (1, 4).
Hand Hygiene:
In healthcare, washing your hands or using alcohol based hand sanitizer is known as hand
hygiene and is an essential part of preventing the spread of germs (5).
The World Health Organization created the 5 Moments for Hand Hygiene to help encourage
timely handwashing. These moments include: before touching a patient, before performing a
procedure, after potentially coming in contact with body fluid, and after touching a patient and/or their surroundings. Even if wearing gloves, hand hygiene must still occur (5).
Conclusion:
While HAIs remain a challenge in healthcare, hand hygiene and infection control protocols help reduce the spread of pathogens and keep patients, visitors, and healthcare staff safe.
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