Guidance on the use of personal protective equipment (PPE) for health workers.

Updated Conventional Use of PPE guide

The Guide to Conventional use of PPE has been updated and is effective as at 14 December 2020; 

  • Tier 0 is currently not applicable.
  • Tier 1– No change and is applicable for all patients or clients who are negative coronavirus (COVID-19) cases. This includes tested negative, a cleared case or a person who screens negative.
  • Tier 2– The definition of Tier 2 has been redefined. It is now only applicable to healthcare workers providing care to or those exposed to a person who is deemed low-risk suspected to have coronavirus (COVID-19) (excluding low-risk suspected patients where an aerosol generating procedure is performed and/or there is a risk of aerosol generating behaviours).
  • Tier 3– The definition of Tier 3 includes all scenarios where care is provided to or healthcare workers are exposed to high-risk suspected or confirmed coronavirus (COVID-19) patients.

The table below provides definitions relating to coronavirus (COVID-19) status. The guidance includes further definitions and examples to inform application.

Confirmed cases of coronavirus (COVID-19)

1. A person who tests positive to a validated SARS-CoV-2 test

High-risk suspected cases of coronavirus (COVID-19)

1. A person in quarantine for any reason (including; being a close contact of a confirmed case of coronavirus (COVID-19) or a returned traveller from overseas in the last 14 days) with or without a compatible clinical illness.

2. A person with a compatible clinical illness who meets one or more of the following epidemiological risk factors in the 14 days prior to illness onset:

o Contact with a confirmed case as defined by public health

o Was employed in an area where there is an increased risk of coronavirus (COVID-19) transmission for example,

- hotel quarantine workers or any workers at ports of entry,

- aged care workers/ healthcare workers

- other high-risk industries (such as abattoirs) where there are known cases /or high levels of community transmission,

o Lived in or visited a geographically localised area at high risk as determined by public health unit

Low-risk suspected cases of coronavirus (COVID-19)

1. Have symptoms that could be consistent with coronavirus (COVID-19) (for example, cough, sore throat, fever, shortness of breath or runny nose) but no epidemiological risk factors as listed in the high-risk definition.

*Where a patient’s history cannot be obtained, they should be considered as a Low-risk suspected case until further screening information can be obtained, at which point a revised diagnosis of the patient’s condition can be made and appropriate changes to PPE implemented.

Negative coronavirus (COVID-19) cases

1. A person who tests negative to a validated SARS-CoV-2 nucleic acid test

2. A person who is a cleared case

3. A person who screens negative and/or has no clinical or epidemiological risk factors for coronavirus (COVID-19)

Download the updated Guide to the conventional use of PPE (Word).

P2/N95 respirators

  • Healthcare workers must wear a N95/P2 respirator
    • at all times when providing care to high-risk suspected and confirmed coronavirus (COVID-19) patients, regardless of the amount of time in contact.
    • undertaking an aerosol generating procedure (AGPs) on a person assessed as low-risk suspected, high-risk suspected or, or a confirmed coronavirus (COVID-19) case.
    • providing care to a person assessed as low-risk suspected, high-risk suspected or a confirmed coronavirus (COVID-19) case and there is a risk of aerosol generating behaviours.
  • Use of N95/P2 respirators are not required for healthcare workers
    • undertaking surgery or AGPs on patients who are not low-risk suspected, high-risk suspected or confirmed to have coronavirus (COVID19) (Tier 1 PPE precautions)
    • working at a coronavirus (COVID-19) testing site and/or undertaking testing for coronavirus (COVID-19) (Tier 2 PPE precautions)
    • patients with aerosol generating behaviours who are not confirmed or assessed as low or high-risk suspected of coronavirus (COVID-19) (Tier 1 PPE Precautions).
  • If the risk of bodily fluid splash is low, staff may wear a non-fluid resistant P2/N95 respirator with a face shield.
  • Do not use P2/N95 respirators with a valve. The air you exhale is likely to not be filtered and may expose other healthcare workers and patients.

Eye protection

  • Healthcare workers who are directly involved in treating patients are required to wear eye protection for all confirmed, low-risk and high-risk suspected cases of coronavirus (COVID-19).
  • Eye protection options include; a face shield (where practical), goggles or safety glasses.
  • Reusable face shields should be chosen over single-use face shields, where possible. For reusable face shields, a process needs to be in place to ensure appropriate decontamination and storage between uses (i.e. meal breaks) and at the end of a shift/use.

Factsheet - Use of eye protection during the COVID-19 pandemic for healthcare workers (Word)

Staffing

  • Keep staffing in high-risk areas to the minimum required to provide appropriate care and ensure patient safety. 
  • Wherever possible, avoid situations where other staff attend these areas .

Extended use

  • Unless damp or soiled, staff may wear a surgical mask, P2/N95 respirator for up to four hours.
  • Isolation gowns may be used for extended periods in specific cohorting environments.
  • Single-use goggles and face shields can be worn for an entire shift. However, eye protection must be replaced after assisting with an aerosol generating procedure.
  • Where single-use face masks/face shields/goggles are used for extended periods and are needed to be removed to eat and/or drink, hand hygiene and sanitising should be maintained.
  • For reusable face shields a process needs to be in place to ensure appropriate decontamination.
  • Remove and dispose of all items before going on a break and replace before resuming work.
  • Change gloves between every patient interaction.

Read Coronavirus (COVID-19) Infection control guidelines Version 5.0 - 26 October 2020 (Word) for more on extended use.

Employers and individuals need to consider strategies to minimise the impact of heat and heat stress, particularly during the warmer months. Controlling heat stress in health and human services is a guide for employers and their staff to prevent heat related illness at work, when wearing personal protective equipment (PPE) during the coronavirus (COVID-19) pandemic response.

For health service PPE supply enquiries, please contact the following:

Service type Primary source of PPE
NDIS The Commonwealth Department of Health: NDISCOVIDPPE@health.gov.au
Private aged care services The Commonwealth Department of Health: agedcarecovidppe@health.gov.au
Private hospitals Private suppliers

Public Hospitals can request PPE through the Zycus online ordering portal. Other DHHS-funded services can request PPE through Covid19PPErequest@dhhs.vic.gov.au

What is the correct PPE use and when should PPE be used?

Take a look at our Guide to the conventional use of PPE (Word).

We also have other resources:

Further advice can be found in the COVID-19 infection control guidelines - Version 5.0 - 26 October 2020 (Word).

Infection control posters and signage for workplaces are also available:

What is the current advice on use of masks by the general population?

See the Chief Health Officer’s latest for Victorian communities advice.

Where can GPs gain access to gown supplies?

If you are having trouble sourcing single use fluid repellent gowns from your normal supplier, there are steps to consider: 

Do I need to wear full PPE when examining a patient with an upper respiratory tract infection?

The current clinical criteria for testing for coronavirus (COVID-19) include an acute respiratory tract infection (for example, cough, sore throat, shortness of breath, runny nose or anosmia). For anyone who meets these clinical criteria, full PPE will be required to examine the patient.

Can we wear the same PPE and swab multiple people?

The use of some PPE can be extended for sessions such as swabbing multiple people in a testing clinic. Masks, protective eye wear and gowns can be used for an extended period in these circumstances.

Gloves must be changed, and hand hygiene performed between each patient. Masks may be worn for up to 4 hours or unless damp or soiled. Goggles and gowns may be used for a similar period but must be replaced if they become soiled. 

When single-use PPE is removed it must be disposed of and not reused. If reusable, it must be cleaned and disinfected before reuse.

Further resources