Hand sanitiser, medical scrubs, face masks, disposable aprons, there are many different items classed as NHS PPE, all with proper uses. When you combine the number of items available with the number of NHS roles that require specific PPE, it can be challenging to understand how best to stay safe.
Put together by the UK’s most trusted supplier of healthcare workwear, Alexandra, this guide will walk you through NHS PPE. It will explain:
Why PPE is so important
What the general NHS guidelines are around PPE
How to stay safe while wearing gloves
How to stay safe wearing ppe disposable aprons
How to stay safe while wearing full-body gowns and coveralls
The safest surgical masks
The best footwear to keep medical staff safe
Where to purchase safe NHS PPE
As a supplier of PPE to the NHS, Alexandra wants to make sure that NHS workers and procurement staff know how best to keep themselves and their colleagues safe.
Why is PPE so important?
In healthcare, personal protective equipment (PPE) is important to act as a barrier between the wearer and any infectious substances, such as viruses, bacteria or fungi. The barrier reduces the risk of the wearer being exposed to the infection and lessens the likelihood of further contamination.
Specialist types of PPE exist across all sectors. A well-known example is hardhats and high-visibility wear on building sites. In healthcare, PPE refers to the following garment types: face masks, respirators, eye protection, foot protection and body clothing.
How can NHS workers be protected from coronavirus?
PPE keeps NHS workers protected during the COVID-19 pandemic by providing an effective barrier between them and the virus. In this way, PPE gives protection from coronavirus COVID-19 in the same way it does to other viruses, bacteria or fungal spores.
For the best protection against COVID-19, healthcare workers should wear filtering face pieces to at least FFP2 standard but preferably FFP3. More information on these different standards can be found later in this article.
What the NHS says you should look for in safe PPE - an overview
To ensure healthcare workers remain adequately protected from Coronavirus, they should follow their workplace guidelines. For example, they might be expected to wear face masks (to Type II, TypeIIR, FFP2 & FFP3 standards), gloves (sometimes two pairs at once), scrubs, specialist footwear (such as clogs), footwear coverings and disposable aprons.
The following are general principles the NHS says all PPE must adhere to. All PPE should be:
Located close to the point of use and transported in a clean receptacle
As situations can change rapidly, and healthcare workers can quickly find themselves in a potentially infectious situation, NHS workers must ensure their PPE is close to hand. In domiciliary care, where PPE doesn’t always have to be worn, the staff member should ensure it is always clean and readily available, stored in a place where it won’t get contaminated.
Stored in a clean, dry area
Fluids can easily carry infectious substances or become a breeding ground for bacteria and fungi, so it’s paramount that PPE is stored somewhere clean and dry so as not to become contaminated. A pre-contaminated piece of PPE could end up infecting the wearer, their colleagues, patients and any surfaces they come into contact with. Therefore, PPE must be kept clean and dry to be effective as a barrier to infectious substances.
Within the expiry date
All PPE has expiry dates, and many items have a reasonably short shelf life. For example, nitrile gloves can become fragile, and their material quickly disintegrates. Therefore, ensure you check the expiry dates of your PPE regularly and discard if the date has passed.
Single-use unless specified by the manufacturer
PPE is made to be reusable or single-use. Single-use items are often ones such as disposable gloves or disposable aprons. These are not designed to be washable, so they will not withstand the industrial laundering process needed to decontaminate them. Therefore, staff must always follow the manufacturer guidelines.
At Alexandra, we stock a wide range of disposable PPE, including disposable aprons, disposable coveralls and disposable face masks. You can view our range of disposable hospital PPE here.
Changed immediately after every patient, depending on role
Many workplaces insist that all staff in clinical roles change some or all of their PPE between seeing each patient, so for nurses on wards, this might mean swapping gloves or aprons. For surgeons, it means changing the entire uniform. Changing PPE helps stop the spread of infection between patients and staff and helps to keep everyone safer.
Disposed of in the correct area
The removal of PPE is just as important as the donning of it. Depending on their role and the type of PPE they’re wearing, staff might have to dispose of their items in the non-infectious or infectious clinical waste bins. Again, staff should consult their workplace for guidance on which items should be disposed of in which waste area.
Discarded if damaged
PPE cannot properly protect the wearer if it is damaged. For example, something such as a hole could let infectious substances through to the wearer to infect them. loose threads and frayed edges can easily dip into infectious material, causing the wearer to contaminate sterile surgical sites or equipment unknowingly. Therefore, when donning PPE, healthcare workers should thoroughly examine it for defects to ensure it will offer them a complete layer of protection.
Decontaminated after each use
PPE items meant to be re-used must undergo a strict cleaning process to ensure they’re decontaminated. Washing guidelines differ between garments, and you should check your workplace instructions for more information. A 60ºC wash for at least 30 minutes is typical, but for items such as surgical scrubs, this can sometimes be as high as 80ºC.
Alexandra’s scrub tunics are suitable for a 60ºC wash in line with infection prevention and control guidelines.
How to stay safe while wearing gloves
Alongside their general guidelines for what to look for in all PPE, the NHS also have policies broken down by item type.
The NHS says safe gloves must:
Be able to provide protection when exposure to bodily fluids is likely
Bodily fluids carry infections, so it’s paramount any healthcare worker is protected from infectious bodily fluids touching their skin. Hands are particularly prone to contamination as they are used to care for the sick and wounded. Therefore workers should wear the correct gloves for their role. Safe gloves must be strong enough to withstand tasks while giving the wearer enough dexterity to complete them.
Not be contaminated with alcohol-based hand rub
Alcohol-based hand sanitiser shouldn’t be used on reusable or disposable gloves. Alcohol can weaken the material the gloves are made from, making them more likely to disintegrate during use and put the wearer at risk of infection. In addition, alcohol could also affect the patient should it enter surgical or wound sites.
At Alexandra, we stock a range of gloves for use in medical settings, including packs of disposable nitrile gloves. You can view our range here.
How to stay safe while wearing a disposable apron
Aprons are a crucial piece of PPE because they add a layer of protection for the wearer’s body at the height where they’re most likely to be tending to the sick or injured. NHS guidelines say aprons must:
Be able to protect a uniform when contamination is likely
“When a contamination is likely” will be outlined by your employer. In general, this is dealing with surgical procedures or the care of a patient directly after one. This will be a time when contact with bodily fluids is likely, so an apron must be able to provide a waterproof protective barrier on top of your clothing, such as surgical scrubs or tunics.
You can purchase a disposable apron from Alexandra, where we stock them in packs of 100. At 20 microns thick and made of polythene, they provide an effective waterproof barrier ideal for use as medical PPE.
How to stay safe in full body gowns & coveralls
Full body gowns and coveralls make up the central portion of a clinician’s PPE. With such a large area to cover, you must stick to NHS guidelines when purchasing these garments. The NHS says full-body gowns and coveralls must:
Offer protection when undertaking aerosol-generating procedures
Aerosol-generating procedures include any surgical procedure that might generate airborne particles. In these instances, infectious substances could be in the air, so full-body gowns and coveralls need to offer protection without holes or gaps from head-to-toe.
Alexandra sells disposable full-body coveralls in boxes of 50 in sizes ranging from small to extra large. With their elasticated cuffs and ankle cuffs, they provide suitable protection and retain excellent freedom of movement for the wearer.
Provide protection from splashing of bodily fluids
Coveralls need to be waterproof to stop any splashes soaking through and contaminating the wearer. They must also have a tight seal around any zips or fastening to ensure no fluids can penetrate small gaps.
Our washable isolation gown is perfect for full-body protection when working with infectious fluids. Made of a fluid repellent fabric, the gown is suitable for up to 25 washes at 60ºC, making it more environmentally friendly than single-use alternatives.
How to stay safe while wearing eye protection
Eyes are an entryway into the body for viruses, bacteria and fungal spores, much like the nose, throat and ears, so they need to be adequately protected. The NHS says eye protection must:
Not be touched when being worn
As the outside of the eye protection can become contaminated with splashes or other debris, the wearer might contaminate their hands if they touch them. Therefore eye protection needs to be comfortable and fit well enough that the wearer doesn’t feel the urge to readjust during their shift constantly.
How to stay safe while wearing surgical masks
The most common way people become infected with viruses, such as coronavirus, is through the nose and mouth. Therefore donning a face mask that offers the correct level of protection for the wearer’s role is vital. PPE face masks for healthcare settings come in several forms: Fluid Resistant Surgical Face Masks (Type IIR), Surgical Face Masks (Type II), FFP2 & FFP3.
Type II Face Masks
Both Type II face masks have a BFE of 98%, which means they will filter out up to 98% of exhaled airborne particles, including viruses, bacteria and fungal spores. However, it is important to note these masks stop the wearer from infecting the surrounding environment but do not protect the wearer. This is because type II face masks don’t have a tight enough seal around the face.
Fluid Resistant Surgical Face Masks (Type IIR) are worn in surgical settings to protect against the wearer exhaling infectious bodily fluids into the surgical site. In addition, they are designed to be splash-resistant, so they are ideal for being worn during surgical procedures.
Surgical Face Masks (Type II) are designed to prevent the spread of infectious substances. This type might also be commonly used by the general public when shopping or on public transport.
The NHS typically uses Fluid Resistant Surgical Face Masks (Type IIR), which must:
Be well-fitting and fully cover the nose and mouth
To do this, any mask must be adjustable to properly fit the wearer and form a protective seal around their face.
Filtering Face Pieces
The FFP stands for ‘filtering face pieces’, and these are a European class of respirators designed to protect the wearer from infection. FFP2 and FFP3 are effective at protecting the wearer from viral transmission, such as COVID-19.
FFP2 masks have a minimum of 94% filtration and a maximum of 8% leakage to the outside. These masks are held to your face by an ear loop and typically last for 3-8 hours.
FFP3 face masks are the most effective class for protecting both the wearer and others. They have a minimum filtration of 99% and maximum leakage of 2% to the inside. These masks are typically fitted to the face for a snug fit and have a valve to help reduce the build-up of moisture on the inside.
The best footwear to keep medical staff safe
Footwear is needed to keep the wearer safe from fluids or sharp objects on the floor. The NHS recommends any footwear must:
Have a slip-resistant sole
To counter the risk of slipping on wet floors, any shoes worn by clinical staff should have a low-heel, slip-resistant sole. In addition, the shoes should ideally be wipe-clean and waterproof to stop infectious materials from getting inside them.
Our ToffeIn AktivKlog is designed for use in healthcare settings. Featuring a closed heel to hold your foot securely and side vents to keep your feet cool, they’re more comfortable to wear during long shifts. In addition, their Grip-Safe Sole gives slip resistance and greater penetration resistance than other lightweight footwear.
Have a sole that cannot easily be penetrated
Medical settings can be filled with many sharp instruments, so any footwear should protect the wearer with a thick sole. Thick soles prevent foreign bodies from penetrating the shoe and reaching the wearer’s foot, which could cause infection.
Tips for choosing safe PPE
Alongside the general and specific NHS guidelines for choosing safe PPE, the wearer can make informed choices that make their work less likely to be hazardous.
Choose comfortable PPE
Where possible, healthcare workers should choose PPE that is made to fit their body shape and is breathable. A well-fitting garment that stops them from overheating on shift will make the work bearable. It will also reduce the temptation to work without adequate protection.
Choose well-made PPE
Healthcare workers who have to source their PPE should make sure they purchase from an official NHS supplier. This ensures the PPE is the right quality for the tasks they need protection from and ensures they remain safe.
Alexandra is one such supplier, having supplied the NHS with uniforms since the service was founded. Having grown with it, we’ve gone on to become the UK’s most trusted manufacturer of healthcare workwear and have received a Royal Warrant to trade.