Hospital hygiene and protective clothing
Special protective clothing is especially important in sensitive areas where patient and task-related caution is required. It creates a secure barrier between the wearer and his surroundings. As a result, their application is also referred to as a "barrier measure." The scope is determined by the personnel risk, the risk of germ spread, and the risk of patient infection.
Protective clothing for hospital hygiene: This is the typical scope
In the following sections, we will go over gloves, respiratory protection masks, overalls, and other equipment components in greater detail.
Medical protective gloves protect against contact with bodily fluids, excretions, or liquid chemicals. These can enter the human circulatory system directly or indirectly (secondarily) as a vehicle through the skin of the hands - for example, B. over existing wounds, cracks in dry skin, or even puncture wounds. Protective gloves are used for a variety of applications, each with its own set of material properties and requirements. So, for example, the substance to be repelled and potential mechanical stresses should always be considered when selecting gloves. If there is an increased risk of glove perforation, it is best to wear two pairs of gloves on top of each other.
Mouth and nose protection generally has the task of ensuring protection against pollutants (e.g. microorganisms) in the air we breathe. How well such mouth and nose protection can work depends on the total leakage with such particle-filtering half masks (Filtering Face Pieces = FFP). (the sum of existing leaks). In addition to possible unscheduled permeability at the exhalation valve, two main factors are responsible for this:
1. Miss Leakage
It rises as the number of leaks on the face increases. These are known as sealing lines.
Wearer-dependent characteristics, such as a beard or increased hair growth in the area of the sealing line, can reduce the respirator's performance. It should be noted that the health risk is increased in this regard (especially in the case of indications for higher quality respiratory protection, such as FFP 2 and FFP3 masks).
2. The filter path:
The lower this value, the better the particle separation efficiency and avoidance of complete penetration. Layer thicknesses and electrical fiber properties, for example, are both to blame.
Gowns (reusable gowns & disposable gowns)
In general, the protective gown protects the employee wearing it from contamination of his area clothing or work clothing with infectious agents of any kind. As a result, the protective gown is worn in addition to and depending on the situation. In general, it is long-sleeved and has a cuff that closes securely at the back and neck. The type of gown chosen is determined by the activity, the risk of contamination, and the potential for moisture penetration. In the case of single-use products, it is recommended that they be disposed of immediately after use. Multiple coats should only be washed using a proven, effective, and disinfecting method, as well as agents from the RKI or VAH list.
Other equipment items are listed below:
→ The hair protection is part of personal protection and helps the wearer as well as the patient to be treated to avoid contamination with organic material. Especially in the case of invasive measures, such basic precautions should be taken without exception.
→ The goggles/face protection (if there is a risk of aerosol formation) is primarily helpful in protecting against infectious material or hazardous chemical substances. The protection should be liquid-tight and equipped with side protection, if necessary also low-fog/mirror-free. In addition, the glasses or face protection must be able to be disinfected.
→ The liquid-tight disposable apron is worn (due to the risk of soaking) over work, field or private clothing if contamination is to be expected. It is made of cotton blended fabric, microfiber or plastic and should be disposed of directly or professionally after you have finished your activity or changed patients.
→ Shoes (e.g. field shoes, rubber boots/galoshes). Of course, these are only necessary for defined activities or in areas with protective clothing. They should be liquid-tight, non-slip and chemically or thermally disinfectable and antistatic for the operating room or intensive care unit.
Surgical clothing augments work clothing in areas where there is a high risk of infection, such as operating rooms and anesthesia, intensive care units, and the blood donation and preparation area of the blood bank.
Of course, there is a color distinction between departmental clothing and work clothing. In the operating room, for example, surgical attire is required. Surgical shoes, hair protection, and mouth and nose protection are also worn in the operating room. For operations where moisture penetration is possible, liquid-tight surgical gowns must be used. Protective goggles must be worn if aerosols and/or secretion splashes are expected. Before putting on or taking off the area clothing, hygienic hand disinfection must be performed.
Medical devices include surgical gowns, medical protective gloves, mouth and nose protection, and hoods. The Medical Devices Act establishes the legal basis for the intended use (Medical Devices Act, MPG, and the Medical Devices Operator Ordinance, MPBetreibV). DIN or EN standards specify the testing requirements for these products. Personal protective equipment (PPE) directive (89/686/EEC) is a European directive that is critical for occupational safety.
Clear regulations for occupational safety in hospitals
There is often an indication for wearing a protective gown, respiratory protection and gloves at the same time. The order in which to dock and undock and what needs to be considered is described below as an example.
Step 1 Putting on the protective gown
Remove the protective gown with your (clean or disinfected) hands.
Slip into the right and left sleeves and then pull the smock all the way over your shoulders
The smock now covers the whole body from the neck to the knees and the arms to the wrists.
Wrap the gown around your back and fasten it with the fasteners at the neck and waist.
Step 2 Donning the respirator
Fasten the breathing mask with the fastening straps or the elastic band at the center back of the head and in the neck area.
Press the nose clip in such a way that there are as few leaks as possible.
Position the mask comfortably on the face and below the chin.
A tight fit test (fit check) is particularly recommended for the use of the respirator with an indication of the filter performance from FFP 2. Place both palms covering the half mask. Then take a deep breath in and out. If you feel your exhaled air escaping quickly around the edges of the mask (especially around the chin and bridge of the nose), refit the mask.
Step 3 Putting on the protective gloves
First, only remove one protective glove from the glove pack.
First put this protective glove on the dominant hand. Be careful not to touch the outside of the glove as much as possible and avoid contact with your face and other surfaces.
Pull the glove over the wrist and gown waistband.
Now remove the second glove with the gloved hand.
Hold the glove by the cuff while slipping the glove over the other hand and gown cuff.
Now both gloves can be adjusted in the seat.
Step 4 Take off the protective gloves
With the other hand, gently lift a glove by the outside of the cuff without touching the skin (outside is potentially contaminated).
Now pull the glove from the wrist down to the fingers. The inside of the glove is turned outwards and the entire glove is unrolled from the hand.
Hold the unrolled glove in your still gloved hand.
The ungloved hand now reaches under the gauntlet of the gloved hand. The glove is also pulled off in such a way that its inside is turned outwards and pulled over the glove that is still held in the hand and has already been unrolled.
Discard both gloves.
Step 5 Take off the protective gown
First, unfasten the neck and waist fasteners (outsides potentially contaminated).
Using a peeling motion, lower the top half of the gown.
Grab the inside of the left shoulder with your left hand and the inside of your right shoulder with your right hand.
Pull down the smock, now turned inside out.
Keep the gown away from your body while disposing of it formed into a bundle.
Step 6 Doff respirator
Avoid touching the potentially contaminated mask if possible.
With clean and disinfected hands, first grab the lower elastic band at neck height.
Then also grab the rubber band, which is located at the height of the middle of the head.
Now pull both straps forward over your head.
Holding both straps, you can now detach the mask from the field of vision.
Finally, an adequate disposal of the protective mask is planned.