Next, fold the main fabric in half, with the right sides facing inward. Line the template with the fabric and secure them together with sewing pins. This will ensure that the fabric will not move while you work. If families refuse to support these actions, discuss with your manager what additional steps could be taken to encourage the family/carers to be more proactive. Any allergic type reactions to PPE, including skin rashes, should be reported using the organisations incident reporting form and through the yellow card reporting system to the MHRA.

Under health and safety legislation, employers have a legal duty to ensure suitable and sufficient risk assessments are carried out and adequate control measures are put in place to reduce the risk of harm to staff and patients, so far as is reasonably practicable. This includes identifying when PPE is required, and the type of PPE which should be used. PPE is designed to protect you from harmful substances such as chemicals or infectious agents. In some situations such as during the pandemic, it can also help prevent the transmission of infection between staff and patients. The type of PPE you need will depend on the risk assessment, which should include the environment you work in and the procedures you carry out. Respiratory protective equipment (RPE) such as FFP3 masks are a form of PPE and, where a risk assessment or national guidance indicates that they should be used, they must be fit tested by a person competent to do so. The NMC statement on personal protective equipment during the COVID-19 pandemic(April 2020) supports the RCN guidance and reflects the realities of clinical decision-making in the context of this pandemic. The RCN also recognise that certain health conditions will make it more difficult to tolerate wearing PPE. Employers should assess any risks to these individuals and make necessary adjustments under both health and safety and equality law. See ‘PPE for staff with disabilities or impairments’ above. You can also see our Health ability passport guidance. Further information There are two fit test methods, qualitative and quantitative. HSE’s guidance requires a fit test report/certificate to be made available to the employee to include the date, method and make and model of mask they have been fit tested for. RCN guidance on skin health, also RCN publication on Maintaining skin health when using PPE. Raising concerns

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The Health and Safety Executive also provides guidance for employers and employees on reasonable adjustments. Raising concerns When considering gloves members should also review if a plastic apron is required. Aprons should not be worn routinely and only if required. Where risk assessments require staff to wear FFP3 masks, all staff must have passed a face fit test for the mask being worn. Further information The Equality Act 2010 (and in Northern Ireland the Disability Discrimination Act 1995) states that employers have a duty to make reasonable adjustments for employees who meet the definition of disabled. This applies to PPE equipment and the processes around administering PPE. The RCN believes that reasonable adjustments should be granted whether this definition is met or not, on the grounds that reasonable adjustments help us to work to the best of our abilities. The RCN’s advice guide on disability discrimination provides lots of helpful information on disability and your employer’s responsibilities.

Our guidance on skin health is here along withour publication on maintaining skin health when using PPE. Raising concerns

Your organisation should provide accessible information on this and on what the household can do to reduce risks, in advance of and during any visits. You can also see our COVID-19 workplace risk assessment toolkit. Guidance for adult social careis also available Some of the patients I visit refuse to have the window open where I am working to increase ventilation. What should I do? Symptoms can be compounded when having to wear PPE, especially for long periods of time, and it is important that staff are supported to enable them to cope in these challenging times.