What are the 5 PPE in nursing? Your essential guide to safety

According to the World Health Organization (WHO), personal protective equipment (PPE) is essential for safeguarding healthcare workers, especially nurses, from infectious diseases. To minimize risk and prevent the spread of contamination, it is crucial for nurses to understand what are the 5 PPE in nursing and how to use them correctly.

Quick Summary

The five essential personal protective equipment items in nursing are gloves, gowns, masks, eye protection (goggles or face shields), and respirators. Each item forms a critical barrier to protect the healthcare worker from exposure to infectious materials, minimizing the risk of contamination and spread of pathogens.

Key Points

• Gloves: Protect hands from infectious materials and are essential for any direct patient contact. They must be changed frequently to avoid cross-contamination.

• Gowns: Protect the nurse's clothing and skin from splashes and sprays. Different levels of gowns are used based on the expected level of fluid contact.

• Masks & Respirators: Masks block large droplets, while respirators (like N95s) filter small airborne particles. The choice depends on the transmission route of the pathogen.

• Eye Protection: Goggles or face shields safeguard the mucous membranes of the eyes from infectious materials. They must fit snugly and cover the eyes completely.

• Proper Protocol: The correct sequence for putting on (donning) and taking off (doffing) PPE is as critical as the equipment itself to prevent self-contamination.

• Risk Assessment: The specific combination of PPE a nurse needs to wear is determined by assessing the anticipated level of exposure and the type of precaution required.

• Training and Compliance: Continuous training and strict adherence to institutional guidelines and CDC protocols are essential for effective infection control.

Why Is PPE So Important in Nursing?

Nurses are on the front lines of patient care, placing them at increased risk of exposure to hazardous materials, bodily fluids, and infectious agents. When used correctly, personal protective equipment acts as a vital barrier, blocking the transmission of these infectious materials and creating a safe environment for both the nurse and the patient. Proper PPE use, alongside strict hand hygiene, is a cornerstone of effective infection control practices within any healthcare setting.

A Detailed Look at the 5 Core PPE Items in Nursing

Understanding each component of PPE is the first step toward effective infection prevention. The specific combination of PPE used depends on the level of precautions required for each patient encounter.

1. Gloves

Gloves are one of the most frequently used items of PPE and are essential for preventing hand contamination. They protect hands from contact with blood, body fluids, mucous membranes, and non-intact skin.

• Types: Commonly available in materials like nitrile, vinyl, and latex. Nitrile is often preferred due to its strength and puncture resistance, as well as addressing latex allergy concerns.
• Proper Use: Disposable gloves are single-use only and must be changed between patients and after touching contaminated surfaces.

2. Gowns

Protective gowns or aprons are worn to protect the nurse's skin and clothing from contamination.

• Coverage: Gowns should fully cover the torso, arms from neck to wrist, and wrap around the back.
• Fluid Resistance: Different levels of gowns exist, from basic isolation gowns to fluid-resistant ones used in higher-risk situations.
• Purpose: They are used for standard precautions if contact with blood or body fluids is expected, and for contact precautions during all patient contact.

3. Masks

Surgical and procedure masks are used to protect the mouth and nose from large respiratory droplets, splashes, or sprays of blood and other bodily fluids.

• Protection Level: These masks offer a good barrier against large droplets but are not designed to filter out smaller airborne particles.
• Use: They are part of standard, contact, and droplet precautions. For example, they are essential when caring for patients with influenza.

4. Eye Protection (Goggles and Face Shields)

Eye protection is critical for shielding the mucous membranes of the eyes from splashes, sprays, and respiratory secretions. Personal eyeglasses are not considered adequate protection.

• Goggles: Provide a sealed barrier around the eyes and are especially effective against droplets and splashes.
• Face Shields: Offer a broader range of protection, covering the entire face and wrapping around the sides. They are often used in conjunction with a mask for additional safety.

5. Respirators (N95, N99, N100)

Respirators are advanced respiratory protection devices designed to filter out at least 95% of very small airborne particles.

• Function: They form a tight seal around the face to prevent the inhalation of infectious aerosols.
• When to Use: Respirators are required for airborne precautions, such as when caring for patients with tuberculosis or performing aerosol-generating procedures.
• Fit-Testing: Proper fit is essential for effectiveness, and healthcare workers must be fit-tested to ensure a secure seal.

Proper Donning and Doffing Procedures

Putting on (donning) and taking off (doffing) PPE in the correct sequence is critical to preventing self-contamination.

Donning Sequence (Putting On):

1. Hand Hygiene: Wash hands with soap and water or use an alcohol-based sanitizer.
2. Gown: Put on the gown first, securing ties at the neck and waist.
3. Mask or Respirator: Place the mask over your mouth and nose, molding the flexible band to your nose bridge. Perform a fit-check for respirators.
4. Eye Protection: Wear goggles or a face shield, positioning it to cover your eyes and face completely.
5. Gloves: Put on gloves last, ensuring they extend over the gown sleeves for full coverage.

Doffing Sequence (Taking Off):

1. Gloves: Remove gloves first, peeling them off inside out to avoid touching the contaminated outer surface.
2. Gown: Remove the gown by unfastening ties and pulling it away from your body, turning it inside out as you roll it into a bundle.
3. Eye Protection: Remove goggles or the face shield by the headband or ear pieces, avoiding the contaminated front.
4. Mask or Respirator: Remove the mask or respirator last, using the straps or ties and without touching the front.
5. Hand Hygiene: Immediately perform hand hygiene after all PPE is removed.

A Comparison of PPE for Different Precautions

PPE Item	Standard Precautions	Droplet Precautions	Airborne Precautions
Gloves	Worn when contact with blood/body fluids is anticipated.	Same as Standard, worn when entering room.	Same as Standard, worn when entering room.
Gown	Worn when contact with blood/body fluids is anticipated.	Worn when entering room.	Worn when entering room.
Mask/Respirator	Not always required.	Surgical mask is required when entering the room.	N95 or higher respirator is required.
Eye Protection	Worn if splashes or sprays are anticipated.	Required when entering the room.	Required when entering the room.

The Critical Role of Training and Compliance

Even with the right equipment, PPE is only as effective as the nurse using it. Inadequate training can lead to significant errors in donning and doffing, which can result in self-contamination. Healthcare facilities must provide comprehensive training on PPE protocols and conduct regular audits to ensure compliance. Continued education on best practices and proper maintenance, storage, and disposal of PPE is vital for maintaining a safe and healthy environment for everyone. Adherence to guidelines from organizations like the Centers for Disease Control and Prevention (CDC) is non-negotiable for infection control.

For more detailed information on specific PPE use guidelines, nurses should consult the CDC's resources on personal protective equipment.

Conclusion: Your Commitment to Safety

In summary, understanding and properly utilizing the five key pieces of PPE—gloves, gowns, masks, eye protection, and respirators—is a fundamental responsibility for every nursing professional. From routine patient care to high-risk isolation protocols, this equipment forms an indispensable layer of defense. By mastering the correct donning and doffing procedures and adhering to guidelines from authoritative bodies, nurses can effectively minimize the risk of infection transmission and uphold the highest standards of patient and staff safety.

Frequently Asked Questions

Why are there different types of masks used in nursing?

Different masks serve different purposes. Surgical masks are loose-fitting and protect against large droplets, while N95 respirators are tight-fitting and filter out small, airborne particles. The type used depends on the specific infectious agent and the risk of exposure.

Can I reuse PPE like gloves or gowns?

No, disposable PPE such as gloves and most isolation gowns are for single-use only and must be discarded after each patient encounter to prevent the spread of infection.

What is the most important step in using PPE correctly?

While all steps are important, the correct sequence for putting on and taking off PPE (donning and doffing) is arguably the most critical. Improper removal can lead to self-contamination, undoing the protective effects of the equipment.

How do I know what PPE to wear for a specific patient?

The type of PPE required is determined by the patient's condition and the type of isolation precautions implemented, such as standard, contact, droplet, or airborne. Your facility's infection control policies and guidelines will outline the specific requirements.

Why is eye protection necessary if I am wearing a mask?

Eye protection, like goggles or a face shield, is necessary because pathogens can enter the body through the mucous membranes of the eyes. A mask only protects the nose and mouth, making eye protection vital for complete facial coverage.

What should I do if a glove or gown tears during a procedure?

If your PPE is compromised (e.g., a tear), it must be removed and replaced immediately. If your hands or skin are contaminated, perform hand hygiene immediately before putting on new PPE.

Besides the 5 PPE items, what else is crucial for infection control?

Hand hygiene is equally critical. You must wash your hands or use an alcohol-based hand sanitizer before donning and after doffing all PPE, as well as between patients.