Personal protective equipment (PPE) is a category of clothing or equipment specifically designed to protect the wearer from infection. The isolation gown serves as a fundamental barrier in healthcare settings. It is a garment worn over personal clothing or scrubs to prevent the transfer of microorganisms and bodily fluids between patients and healthcare personnel. The use of an isolation gown is a standard practice in infection control, helping to minimize the risk of cross-infection where infectious agents may be present.
Defining Isolation Gowns and Their Primary Role
The main function of an isolation gown is to act as a two-way barrier. It protects the wearer from exposure to potentially infectious materials while preventing the transfer of the wearer’s microorganisms to the patient or environment. Isolation gowns are typically made from non-woven synthetic fabrics, such as polypropylene, polyethylene, or multi-layered materials like Spunbond-Meltblown-Spunbond (SMS). These materials are chosen for their ability to resist fluid penetration while remaining relatively lightweight and disposable.
Isolation gowns differ from surgical gowns primarily in intended application and sterility. Surgical gowns are sterile and designed for use in procedures requiring a sterile field. Isolation gowns are usually non-sterile and utilized in general patient care where contact with blood or bodily fluids is possible. They cover the arms and torso, secured with tie closures at the neck and waist.
How Gowns are Classified by Protection Level
Isolation gowns are classified based on their barrier effectiveness against fluid penetration, using a standard established by the Association for the Advancement of Medical Instrumentation (AAMI). This classification system, known as ANSI/AAMI PB70, sorts gowns into four distinct levels, with higher numbers indicating greater protection against liquids. This grading allows healthcare professionals to select the appropriate level of protection for the specific task and anticipated risk of fluid exposure.
AAMI Protection Levels
The four classifications define the required protection:
- AAMI Level 1: These gowns represent the lowest level of fluid protection and are designed for minimal risk situations. They are suitable for basic patient care, standard isolation, or for use by visitors when there is no expectation of fluid contact, such as during routine patient examinations.
- AAMI Level 2: These gowns provide low fluid protection and are appropriate for procedures that carry a slight risk of liquid exposure. This level is used for tasks like drawing blood or performing simple suturing.
- AAMI Level 3: These gowns offer moderate barrier protection and are intended for tasks where the risk of fluid exposure is higher, such as during arterial blood draws, inserting intravenous lines, or in emergency room settings. These gowns are often made with more robust materials to withstand greater fluid pressure.
- AAMI Level 4: This is the highest classification, providing maximum fluid protection for high-risk, fluid-intense procedures. Level 4 gowns are the only classification tested for resistance to viral penetration, making them impermeable to fluids and infectious materials. They are used in situations where prolonged exposure to large volumes of blood or infectious materials is expected. The distinction between these four levels ensures the gown matches the potential hazard.
Practical Application: Settings and Usage
Isolation gowns are a common feature across a wide range of healthcare environments, including hospitals, outpatient clinics, long-term care facilities, and emergency departments. Their use is mandated when implementing isolation precautions, which are measures taken to prevent the spread of contagious diseases. Gowns are a necessary component of contact precautions, required for patients infected with pathogens that spread through direct or indirect contact, such as Clostridioides difficile (C. diff) or Methicillin-resistant Staphylococcus aureus (MRSA).
The correct usage of the gown involves specific procedures for putting it on (donning) and taking it off (doffing). Proper doffing protocols ensure the contaminated outer surface does not touch the wearer’s skin or clothing upon removal. Following these protocols maintains the integrity of the barrier and effectively prevents the transfer of infectious agents. Isolation gowns are typically single-use and disposable, discarded immediately after patient interaction to mitigate the risk of cross-contamination.