Module 6
Infection Control and Personal Protective Equipment
Facilitator Guide
1. Problem Solving Activity: Using PPE in Healthcare Facilities
Instructions. Six different scenarios are listed below. Assume that these scenarios occur in the
context of no known avian influenza. For each situation, determine which personal protective
equipment (PPE) should be used (you may assume that hand hygiene takes place in each one).
Please choose one or more of the following possible responses:
- None
- Gloves
- Gown
- Mask
- Goggles
- Face shield
Question: What type of PPE would you use for a patient with febrile respiratory illness but
no risk factors for avian influenza when. . .
1. Giving a bed bath?
Facilitator Answer: Surgical mask on the health care worker
2. Transporting a patient in a wheelchair?
Facilitator Answer: Generally none
3. Responding to an emergency where blood is spurting?
Facilitator Answer: gloves, fluid-resistant gown, mask/goggles or a face shield
4. Drawing blood from a vein?
Facilitator Answer: mask and gloves
5. Cleaning an incontinent patient with diarrhea?
Facilitator Answer: gloves and possibly a gown and mask
6 Taking vital signs?
Facilitator Answer: mask
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2. Group Discussion / Brainstorming Activity: Prioritizing PPE during an
Avian Influenza Pandemic
Instructions.
1. Take 5 minutes to read through the following three questions individually and
contemplate responses.
2. Discuss the three questions as a group; designate one group member to record group
responses.
Question 1:
Can you think of any infection control supplies such as clean water, soap, gloves, or masks that
may have limited availability in your area?
Question 2:
If yes, what are the reasons for the possible limited availability?
Question 3:
What could you do if infection control supplies were limited or unavailable during an avian
influenza pandemic?
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3. Assessing Infection Control during an Investigation
Instructions: Read the scenarios given below, and discuss the following questions with your
team or group.
Scenario 1
SARS Outbreak in a Small Health Care Facility
A small health care facility in Tay Ninh, Viet Nam has a basic infection control program in place, but has
never before had a patient with Severe Acute Respiratory Syndrome (SARS). During an outbreak, the top
administrator at the facility has called you to advise him on how to expand the infection control program
to prevent the spread of SARS.
Question: As the expert, how would you advise the facility administrator? Address each
component of infection control infrastructure in your response (Policies, Procedures,
Authority, Human resources, Financial resources, and Engineering resources).
Facilitator discussion cues:
SARS is thought mainly to be spread by infected respiratory droplets and through
contact, although airborne transmission is also possible. So first, the facility would need to
create SARS-specific infection control policies that describe how to handle patients with
suspected or confirmed SARS from the moment they arrive until the moment they leave the
facility. For example, they would need policies describing how to triage patients with suspected
SARS before they enter waiting rooms as well as what PPE the staff should wear when caring for
a patient with SARS. Depending on the number of patients involved in the outbreak, additional
medical and infection control supplies may be required. In relation to this, engineering needs to
prevent the spread of SARS must be considered. For example, depending on the number of
patients and staff in the facility during the outbreak, additional hand hygiene facilities may need
to be set up.
Since the facility already has an infection control program in place, they may be able to
adapt their policies for other diseases spread by droplets, contact, and through the air for SARS.
It would also be important to ascertain that the infection control supervisor has the
authority to work with the medical facility administrators to enforce the infection control
program. It would also be a good idea to establish good communication between the infection
control supervisor and the local and possibly regional public health authorities to coordinate
their efforts.
Next, they will need to create procedures specific to managing SARS patients. For
example, the location of SARS-infected patients in the facility will also have to be considered.
They will also need a procedure detailing how to handle SARS-infected corpses.
Estimating the needed number of staff members can be difficult, since an outbreak is
somewhat unpredictable. However, the need should be estimated for different possible outbreak
scenarios, with the recognition that additional health care workers may be called upon. If extra
health care workers are employed during the outbreak, the facility will need to consider the cost
of additional wages.
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Scenario 2
SARS Outbreak in a Community
This next scenario addresses how infection control concepts could be applied to promote infection control
in the community beyond the health care facility. The leaders of a local community ask you to help them
implement an infection control program.
Question: How would you advise the local leaders in this situation, keeping in mind the
necessary components of infection control infrastructure?
Facilitator discussion cues:
While promoting infection control in a community differs from promoting infection
control in a medical facility, the same concepts can be applied. Local infection control policies
might include having everyone cough or sneeze into a tissue during a SARS outbreak. Officials
might also post signs that demonstrate proper hand hygiene technique around the village. If it is
found that people are disregarding the community infection control program, the local leaders
might (depending on the situation) declare the authority to enforce it. In terms of human
resources, the local leaders may wish to train several citizens to promote infection control in the
community. Money for items such as PPE in the community and media promoting infection
control might also be needed. Leaders may wish to set up additional hand and / or respiratory
hygiene stations around the village as an engineering resource.
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