Learning the proper order of donning and doffing Personal Protective Equipment, aka PPE, is super important for any nurse. So, let’s go over the CDC (Center for Disease Control) recommendations for the donning and doffing of PPE!
Standard Precautions
Let’s first start with Standard Precautions. These are the typical safety precautions taken for every patient in the clinical setting. It includes hand hygiene and gloves. Be sure to always wear gloves when doing your full body assessment. You never know when you’re going to come in contact with blood, bodily fluids, skin tears/wounds, or an indwelling device.
For more information, visit Nursing Fundamentals: A Guide to Infection Control, Identifying Sepsis and Understanding its Care and Treatment, A Guide to Wounds, and A Guide to Pressure Ulcers.
Donning (To Put On)
Don the correct sized gloves that fully covers your wrist
Doffing (To Take Off)
Remove gloves –> Perform hand hygiene before leaving the patients’ room
Pro Tip #1: Keep in mind that gloves are typically the last item to be donned but almost always the first item to be doffed.
Pro Tip #2: You may also use gowns, goggles, and face masks with Standard Precaution patients anytime the patients’ skin is open and there is a chance for splash. When performing wound care for instance. Gowns may also be used when cleaning a large bowel movement to prevent direct skin or clothing contact. If this is the case, follow the next order of donning and doffing.
Donning
Don gown first –> Then the face mask –> And the goggles –> Then the gloves last
Doffing Option #1
Remove saturated gloves –> Then the goggles –> And then the gown –> Lastly remove the face mask with your bare hands on the back ties –> Perform hand hygiene before leaving the patients’ room
Pro Tip #3: There is actually another way to doff PPE that you’ve probably seen in practice but haven’t been taught in nursing school. In this technique, you would remove the gown and gloves together. If you donned the PPE properly, then the gloves will be covering the wrist part of the gown. So when you go to take the gown off by pulling from the front, the gloves will naturally come with it. See the doffing example below.
Doffing Option #2
Remove gown and gloves together –> Then the goggles –> Then remove the face mask –> Don’t forget to perform hand hygiene before leaving the patients’ room
Contact Precautions
Contact Precautions are to be used when there is a chance of being infected simply by touching objects that the infected patient has touched or by coming in contact with the patient directly. Examples where Contact Precautions are used is in patients with MRSA, open wound infections, RSV (Respiratory Syncytial Virus), herpes simplex, or scabies.
In addition to PPE, this patient will need a private room or a shared room with another patient who has the same infectious disease.
Donning
Perform hand hygiene before entering the patients’ room –> Put on gown –> And gloves
Doffing Option #1
Remove saturated gloves –> Then the gown –> And perform hand hygiene before leaving the patients’ room
Doffing Option #2
Remove gown and gloves together –> Perform hand hygiene before leaving the patients’ room
Pro Tip #4: Do not bring personal supplies (like your stethoscope) into a Contact Precautions patients’ room. Instead, make sure to bring the reusable equipment the hospital supplies and leave them in the patients’ room.
Droplet Precautions
Droplet Precautions are used when there’s a chance of becoming infected by respiratory droplets that are larger than 5 mcg. Examples where Droplet Precautions are used is in patients with strep or pneumonia, mumps, rubella, or pertussis (aka whooping cough). Droplet Precaution PPE is the same as Standard Precautions with the addition of a face mask. Your eyes, nose, and mouth must be fully covered before entering a patients’ room on Droplet Precautions. Because of this, be sure to don a clean face mask prior to entering the patients’ room and remove it before exiting the patients’ room.
In addition to PPE, this patient will need a private room or a shared room with another patient who has the same infectious disease.
Donning
Don face mask –> And gloves
Doffing
Remove gloves –> Then face mask –> And perform hand hygiene before leaving the patients’ room
If a gown or goggles are needed, following the donning and doffing order as seen in Standard precautions above.
Airborne Precautions
Airborne Precautions are used when there is a chance of being infected by respiratory droplets that are smaller than 5 mcg. Examples where Airborne Precautions are used is in patients with measles, varicella, or active TB (tuberculosis). A N95 or a powered air purifying respirator (PAPR) are necessary.
In addition to PPE, this patient will need a private room with negative pressure airflow in which the door must remain closed at all times.
Donning
Don a N95 or PAPR that has been fit tested to you specifically prior to entering the room –> Then don gloves
Doffing
Remove gloves –> Perform hand hygiene –> Remove N95 or PAPR after leaving the patients’ room and closing the door behind you
If any other PPE is needed for your Airborne Precaution patient, please refer to the donning and doffing sections above with the addition of a N95 or PAPR.
And that’s it!
How do you remember the donning and doffing order of PPE? Comment below!
And don’t forget to check out the following posts for more nursing info!
- How to Survive Nursing School
- How to Pass the NCLEX in 75 Questions
- Start of Shift Plan for New Nurses
- How to do a Quick yet Effective Head-to-Toe Assessment
- Patient Education: How to Spot a Stroke and Save a Life
- Nursing Fundamentals: Sterile Field Etiquette
Content Reference and Photo Source: Centers for Disease Control and Prevention