Hanoi Medical University

Faculty of Nursing and Midwifery

                                          
        REPORT
ACTUAL SITUATION OF USING  PERSONAL PROTECTIVE
EQUIPMENT DURING COVID-19 AT HANOI MEDICAL UNIVERSITY
HOSPITAL

 Subject: Infection control in nursing care

                                                                           GROUP 2:
                                                                 1)  Đinh Văn Long
                                                                 2)  Vũ Thị Lý
                                                                 3) Hạc Huyền My    
                                                                 4)  Phạm Thị Như
                                                                 5) Nguyễn Mai Phương

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 CONTENT
Abbreviation
A. Overview of current Infection Control activities
B. Content: 
1. Concept of personal protective equipment……………………….….5
2. Classification of personal protective equipment…..…………………5
3. The purpose of using personal protective equipment……...…..…....5
4. Orientation of use….……………………….……………………….....5
4.1. Due to the risk of contact
4.2. Due to situations 
4.3. Due to the type of personal protective equipment
5. Principle of use………………………………………………………..8
5.1. General principle
5.2. Principle of using personal protective equipment in COVID-19
pandemic
6. Results of observation in Hanoi Medical University Hospital….….9
7. Discussion..……………………………………………………………11
C. Conclusion………………………………………………...……………...12
References

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Abbreviation
 PPE: Personal protective equipment

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A. Overview of current Infection Control activities

         Currently, the outbreak of the coronavirus (COVID-19) has become a

pandemic. All of the countries affected by COVID-19 around the world are
taking preventive interventions and doing their best to fight the disease to
prevent its wider spread and reduce mortality. . Public health forces and health
care workers in health facilities are playing an important role in early detection
of cases, finding contacts as quickly as possible, and treating patients.
         With the aim of proactively and improving the capacity to prevent n-CoV
virus infection for health workers during treatment and care of patients, limit the
spread of pathogens to the outside environment, practice The use of personal
protective equipment in isolation prevention (including medical masks, N95
respirators, hats, goggles, gowns, aprons, gloves, boots / shoes) is essential.
          In particular, the types of personal protective equipment used at this time
will vary depending on the context, audience, goals and activities involved. In
addition to being fully equipped with personal protective equipment as well as
relevant knowledge, it is the medical staff who come into contact with an
infected patient or have the task of guiding patients to visit the hospital to follow
the correct procedures. Principle of using personal protective equipment to
minimize the risk of Covid 19. Therefore, we did a small survey on the
implementation of the principles of the use of personal protective equipment at
the medical facility, the Hanoi Medical University hospital, so that we can
clearly see the importance. of the correct use of personal protective equipment
during today's pandemic season.

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B. Content
 1. Concepts
       PPE is any equipment (for example, gloves) worn by a person to protect that
individual from exposure to one or more hazards. 
2. Classification of personal protective equipment    
 PPE includes:
 Basic protective equipment (PPE for standard prevention): hand hygiene,
gown, medical masks, glasses, face.
 Complete Personal Protective Equipment (PPE  for additional
precautions): hand hygiene, gown, hood, gloves (clean, sanitary gloves,
sterile gloves), pants, shoelace (waterproof boots), aperture assorted
medical masks (surgical masks, respirators, N95), goggles, masks for high
risk exposure situations in additional prevention.
3. The purpose of using PPE
 Personal protective equipment can protect patients, the health care worker
from infection with both resident and current microorganisms from the
health care worker, the environment.
 Personal protective equipment also helps to protect the oral, nasal, eye
and skin mucosa of health care workers from splashes of blood and
secretions containing infectious germs.
 Adequate and correct personal protective equipment is the most important
measure in preventing infection for health care workers. 
4. Orientation of use
 4.1. Due to the risk of exposure
 The high and very high risk are those who directly take care of the patient,
do invasive procedures on the respiratory tract, go into an epidemic area
or isolate serious patients, patients have been identified.
 Average risk is those who come into contact with a community of patients
with a diagnosed / suspected illness but are still healthy.
 Low-risk people are exposed to the community, colleagues are suspected
of epidemic, the area is indirectly involved in patient care. 
4.2. Due to the situation
 Prevention of air transmission: Applicable in areas where aerosolization is
performed, especially in close proximity (<2m) and in enclosed, poorly
ventilated areas.
 Prevention of transmission by droplets: COVID-19 is mainly transmitted
by droplets in close proximity to people infected with COVID-19, so
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 wearing a medical mask, hand washing  is the most important measure in
preventing transmission infection. 
  Table 1 : Using PPE due to situation (WHO)
Situation Hand Gloves Gown Face Goggles
washing  Mask
Always before and after X
contacting patients, dirty
environments.
In direct contact with blood X X
and body fluids, secretions,
mucous membranes or skin
are damaged.
If there is a risk of splashes X X X
and spills of blood and
secretions to the health-care
staff’s body
If there is a risk of splashes X X X X X
and spills of blood and
secretions to body and face of
health care staff

            Table 2 :Recommendation for using PPE based on situation (WHO)

Glove Face Gown Goggle shoes shoes Apron
s Mas s cover  leggin
k g
1. Procedure to + + + + _ _
enter the artery.  ±

2.Procedure to + + _ _ _ _
enter the vein. ±

3.Procedure that + + _ _
enters the body ± ± ±
cavity.
4.Endotracheal + + + _ _
intubation, ± ±
tracheostomy.
5.Suctioning + + _ _ _ _
±

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6.Change + + _ _ _ _
bandage. ±

7.Suture. + + + _ _ _ _
8.Obstetrics + + _ _ _ _ _
examination
(internal
examination)
9.Delivering + + + + + _ +
procedure
10.Abortion + + + _ _ _
procedure ±

11.Implantation + + + _ _ _
of the uterus. _

12.Collection and + + + + _ +
handling of dirty _
tools.
13.Collection and + + _ + _ +
handling of dirty _
fabrics.
14.Collection and + + _ _ _ +
transportation of _
waste.
15.Environmenta + + _ + _ +
l sanitation. _

16.Dispose of + + _ + _ +
waste NB. _

17. Contact with + + _ _ _

patients in the _
laboratory.. 
18. Contact with + + + + _ +
the corpse. _

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4.3.Due to the type of Personal Protective Equipment
      - Wear gloves.
      - Use a mask.
      - Use of face and eye masks.
      - Using giant robes.  
5.Principle of use
 5.1. General principles
 Use of rehabilitation facilities recommended by standard precautions
combined with transmission-based prophylaxis appropriate to the
situation in the care of an infected or suspected COVID-19 infection.
 Ensure that a large number of rehabilitation facilities are available in
quarantine, quarantine, laboratory, and body waste disposal areas.
 Rehabilitation means are only effective when applied in conjunction with
other infection control measures such as screening, isolation, surface
sanitation, and waste management.
 The correct instructions and procedures for wearing and disposing of
rehabilitation media should be followed. 
5.2. Principles of using personal protective equipment in COVID-19
 Always wear rehabilitation equipment when handling, examining or
caring for an infected or suspected COVID-19 infection.
 The practice of wearing and disposing of rehabilitation equipment must be
practiced well before taking care of an infected or suspected COVID-19
infection and supervised by a trained member.
 Prepare sufficient rehabilitation means to suit the upcoming situation.
 Wear and remove the rehabilitation media in the buffer chamber before
entering and after exiting the isolation chamber. Avoid contact or
modification of rehabilitative media in the isolation chamber.
 Make sure the rehabilitation facility covers the entire body.
 Change gloves when moving from one retailer to another, change gloves
if torn, VST before putting on new gloves.
 When removing rehabilitation media, pay attention to the following
principles:
 The outer surface of the rehabilitation media has a high risk of
contamination. When removing the outer surface, it must be rolled
in. Do not hold the rehabilitation media when disassembling.
 The front of the rehabilitation vehicle has a higher risk of infection
than the back. Avoid touching the front of the rehabilitation vehicle
with your hands.

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   The disposable means of rehabilitation, which is contagious waste, must
immediately be put in the infectious waste bin (yellow bin) after being
removed. Waste bins must be large enough and have automatic lids. 
6. Situation of using PPE in Hanoi Medical University hospital        
        Table 3: Percentage of health-care workers with correct practice based
on standard prevention.

Content  Right technique 

(n=30)

Number(people Percent(%)
)
Hand washing  after touching each patient 29 96,7
Hand washing after removing gloves 28 93,3

Hand washing  before touching each 30 100

patient
The following hand washing  is in contact 25 83,3
with the environmental surface

Hand washing  before wearing gloves  28 93,3

  
Table 4: Percentage of health-care workers with correct practice in
isolation prevention.
Content  Right technique
(n=30)
Number Percent(%)
(people)
Wear gloves when entering the isolation 30 100
chamber
Arrange patients to transmit by contact route 30 100
and separate patient chamber
Wear an N95 respirator when taking care of 30 100
patients with airborne infections
Keep a distance> 2m when in contact with the 29 96,7

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 patient transmitted by droplets
Collect in a yellow bin / bag all waste 30 100
generated from patient Covid's chamber
Immediately quarantine at the place where a 30 100
patient is suspected or infected with Covid-19
 
      Table 3, 4 shows that the rate of correct implementation of technical
processes is always at a high rate of over 80%, especially hand washing before,
after and after contact with NB at all accounts for a very high rate of over 90%.

7. Discussion
        For the current outbreak of the COVID-19 pandemic, the use of PPE by
health workers in medical examination and treatment facilities is a very
important issue that needs to be paid attention to. Strict adherence to the
Standard precaution and isolation prevention principles combined with
screening of suspected or in close contact with an infected or suspected COVID-
19 infection significantly reduces the spread of COVID. This is clearly shown
through the statistics in tables 3, 4. From there, it shows that:
The health-care worker is properly aware of the importance of hand washing
before touching the patient, before wearing gloves, after contacting with utensils
and objects in the patient's chamber.
      + A high percentage of health workers are aware of changing gloves during
examination among patients.
      + Having a correct attitude about the importance of practice of sorting and
collecting waste and using N95 respirators. 
           Besides, there are still some limitations such as:
 Many departments are not equipped with the necessary facilities to help health
workers perform well Standard precaution and isolation prevention.
     + Most of the health workers are trained only according to specialized
content, not yet trained in general medical examination and import. COVID-19
happened suddenly with many unpredictable developments, requiring health
care workers to have a deep and firm knowledge of infection control. This is
also a big disadvantage for the team of health workers.
It can be seen that the knowledge of the health workers about the internal check-
in is an important factor to improve the attitude of internal control. We realize
that training is an important content that should be prioritized for
implementation in all  infection control programs. It is necessary to include the
education and training of basic knowledge on IME into the program on ME in
order to improve the knowledge of the health workers and serve as a basis for
the health worker to comply with the practice of MEAS specified by the hospita

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C. Conclusion
         In the current complex context of COVID-19, the medical staff plays a
very important role in epidemic prevention. Understanding the current state of
knowledge, attitudes and practices of health workers will provide the necessary
data for training to achieve better COVID-19 prevention. Standard preventive
training has always been considered a low-cost way to improve compliance with
infection control procedures. However, the training and coaching only really
change the behavior of health workers when the training goes hand-in-hand with
practical supervision and equipped with necessary means of infection control.

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References
1. Quyết định 3671/QĐ-BYT ngày 27 tháng 9 năm 2012.
2. Quyết định 1259/QĐ-BYT ngày 20 tháng 3 năm 2020.
3. Quyết định 468 Ban hành ngày 19/2/2020
4. Tạp chí Y Học Thực Hành số 5/2010.

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