Surgical face masks are required as a means of source control. They protect the patient from the wearer during sterile procedures such as surgery and to protect the wearer when there is a risk of splashing or spraying of blood, body fluids, secretions or excretions onto the respiratory mucosa of the nose, mouth and respiratory tract. Therefore, they should be well-fitting fully covering the mouth and nose. The manufacturers’ instructions must be followed to ensure effective fit and protection. They must be worn by:

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The inappropriate use of plastic aprons is common among health workers. Therefore, all health workers should understand the rationale for plastic apron use and assess the potential risk of each task. Therefore, they should not be worn routinely during shifts.

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Note: Type I surgical masks have at least 95% bacterial filtration rates, Type II has at least 98%, and Type IIR has additional splash resistance. Therefore, Type II is not classed as a Fluid-Resistant Surgical Face Mask (FRSM).

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Gloves should be worn when exposed to blood and/or body fluids, secretions or excretions and when handling contaminated items and equipment. Inappropriate use of gloves is common among health workers. Therefore, all health workers should understand the rationale for glove use and assess the potential risk of each task (Refer to the flow chart on Glove use and Selection).

Headwear is not routinely required in clinical areas unless part of theatre attire or to prevent contamination of the environment, such as in clean rooms. They must be well-fitting, completely cover the hair, and worn in theatre settings and clean rooms (central sterile/decontamination units, etc.).

The initial risk assessment of whether PPE is required is based on the risk of transmission of infectious agents to and from the patient. In healthcare, personal protective equipment (PPE), e.g. gloves, aprons, long-sleeved gowns, Fluid-resistant surgical masks (FRSM), eye goggles, face visors and respirators (FFP3), create a barrier between health and care workers and infectious agents from the patient and also reduce the risk of transmitting microorganisms from health and care workers to the patient(s). In addition, PPE may sometimes be used by the patient’s family/visitors if they provide direct patient care (e.g. assisting the patient with toileting). In these circumstances, carers must be fully inducted using PPE and hand hygiene.

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Disposable plastic aprons and gowns are designed to protect uniforms and clothing from soiling during direct patient care. In the majority of cases, plastic aprons will be appropriate. A long-sleeved fluid-repellent gown should be used where extensive contamination by blood and/or body fluids is anticipated or when the patient requires a significant amount of direct care with close skin-to-skin contact.

They should be worn if blood and/or body fluid contamination to the eyes or face is anticipated or likely, e.g. by members of the surgical theatre team and always during aerosol-generating procedures. Personal glasses are not a suitable substitute as they do not provide complete protection.

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