S.P.I.C.E the Strategy: Prevention, Isolation, Containment and Elimination
Personal Protective Equipment is commonly referred to as PPE. PPE is equipment that is designed to minimise exposure to a variety of hazards. So, it is designed to prevent or reduce the spread of infection.
An assessment of the likely exposure to infection will dictate the type of PPE worn.
You may wear enhanced PPE in the home. Wearing enhanced PPE will depend on the zone within the home you are working in and the distance between you and the person you are looking after. The distance between you and the person focuses on the 2-meter rule. Social distancing is part of the strategy in prevention. Refer to SICP 11 for further information on zoning when managing infection risks.
The PPE you will be using in the care home will consist of –
Standard PPE and the Order of Application
- Fluid Repellent Surgical Masks [Type IIR FRSM] – sessional use. A maximum of four hours* [see explanation below]
- Disposable Aprons – single use – apron neck broken and tied high around the neck to protect upper chest
- Nitrile or Vinyl gloves* [see explanation below]
Enhanced PPE
Face Visors
Hair Nets
Over Robes
FFP3 Face Masks* [see explanation below]
Explanation*
Type IIR FRSM – the frequency of change will depend on the zone you are working within.
If you have to move from a high-risk zone to a low risk zone your Type IIR FRSM will need to be changed. See diagram on page 18.
In addition, you are required to changeyour Type IIR FRSM if it becomes soiled, wet or damaged. You should change your mask as soon as this occurs.
You will always DOFF your Type IIR FRSM when you go for a break and DON a new Type IIR FRSM before you go back to work
FFP3 Face Masks or NP25 Face Masks – this type of face mask would be used when caring for someone who requires an Aerosol Generating procedure. This would be on a case-by-case basis and each team member would be fit tested to wear this type of mask
Vinyl Gloves – these are only to be worn in low-risk areas or GREEN zones
Nitrile Gloves – these are to be worn when supporting a person in isolation. Isolation means when a person is cared for in RAINBOW care, BLUE LIGHT Care or RED Case management
Hair Nets – There is a possibility COVID can live on hair. Although this is small risk it is possible when someone is coughing who is COVID positive for the virus to be transmitted onto hair strands
Face Visors – are worn to protect the staff member’s eye from the risk of droplets or secretions from the person’s nose, mouth, lungs or from bodily fluids.
Example of when to change your Type IIR FRSM – this is all about reducing the risk when moving between risks zones.
Doffing your PPE
Apron and Gloves – DOFFED in the zone you have provided support in.
Face Visors – DOFFED in the high-risk zone where you have provided support. Face Visors are single use items when moving between the two high risk areas highlighted in the following table.
Type 11R FRSM – DOFFED at the nearest entrance/exit or break station.
The change of your Type IIR FRSM must only be undertaken at the nearest entrance/exit point or break station in your house to ensure that you are not at any time in the main house without a face mask in place. See SICP 9 Safe Disposal of Waste for further information in DOFFING your PPE.
| ZONE | LEVEL OF CONTACT | MASK Type IIR FRSM /FFP3* | APRON – single use | GLOVES – single use | FACE VISOR – sessional use* | HAIR NET – sessional use |
| GREEN ZONE | When you are NOT providing direct care* to a family member | Yes – sessional use – 4 hourly change | No | No | No | No |
| GREEN ZONE | When you are providing direct care* to a family member who has no SOFT signs or symptoms | Yes – sessional use – 4 hourly change | Yes | Yes – Vinyl or Nitrile gloves | No | No |
| RAINBOW CARE | All contact | Yes – single use | Yes | Yes – Nitrile gloves | Yes – if there is a risk of splashing or the person is coughing, spitting or an AGP performed | No |
| BLUE LIGHT CARE | All contact | Yes – sessional use unless providing care for a signal person in Blue Light Care | Yes | Yes – Nitrile gloves | Yes | No |
| RED CASE MANAGEMENT – POSITIVE LFT or PCR | All contact | Yes – sessional use unless a single case of COVID | Yes | Yes – Nitrile Gloves | Yes | Yes |
How does the PPE protect me and others around me?
The PPE you wear acts as a physical barrier between you and an infection. Therefore, how you DON [put on] your PPE, how you DOFF [take off] your PPE and when you wear PPE are of equal importance. [See SICP 9 for further information]
Blue Light Care – High Risk Zone
Blue Light Care is a high-risk area as we cannot be certain that people living within this area have not been exposed to a transmissible infection prior to admission into the care home.
Blue Light Care areas have a planned staffing team. This is to reduce the risk of an infection being transmitted to other people living in the care home. Refer to SICP 11, Maintaining social/physical distancing (this is the new SICP due to COVID-19). for further detail. There will be times when a staff member from another zone has to ‘cross’ into this area. This is where additional protective clothing is worn if the staff member will be coming within a 2-meter distance of the person living in this zone. The additional measures will reduce the risk of the clothes of the staff member ‘crossing zones’ becoming contaminated with an infectious agent. The additional protective measures consist of an over-robe. The over robe is worn when ‘crossing’ into a Blue Light zone and when direct care with 2 meters of a person living there will be provided. It is not worn when solely working in this zone.
If crossing into RED zone from a lower risk area an overrobe would be worn at all times in this zone.
The over robe is disposed of into RED soluble bag before you leave the zone. An apron is worn over the top of the over robe
Additional Protection when Entering a Blue Light Care Zone and working within 2 meters of a person living in this area
Personal Protective Equipment and the Chain of Infection
How does the use of Personal Protective Equipment fit into the Strategy of S.P.I.C.E?
The personal protective equipment acts as a barrier so it can prevent transmission from one person to another. The way in which your personal protective equipment is donned and doffed can isolate an infectious agent and enable it to be eliminated by safe disposal of clinical waste.
