PPE Donning And Doffing - NCLEX-PN

Protect mucous membranes of eyes from splashes and sprays. Eye protection shields the conjunctiva from infectious droplets or sprays generated during patient care activities like suctioning.

Stop task, remove gloves, perform hand hygiene, don new gloves. A tear compromises the barrier, requiring immediate replacement after hygiene to prevent pathogen exposure and maintain asepsis.

Perform hand hygiene immediately. The front of the mask is contaminated, so touching it requires immediate hygiene to remove transferred pathogens and prevent self-inoculation.

Remove PPE inside the room (before exit), then perform hand hygiene. Removing PPE inside confines contamination to the isolation area, with hand hygiene afterward eliminating any residual microbes.

After securing the gown. Securing the gown first ensures full coverage before gloves are donned to overlap and seal the cuffs, maintaining a continuous barrier.

Wash with soap and water. Visible soil requires mechanical removal with soap and water, as alcohol-based sanitizers are ineffective against certain pathogens like C. difficile spores.

Avoid touching face; if adjustment needed, perform hand hygiene and re-glove. Touching the face with gloved hands risks contamination, so hygiene and re-gloving ensure clean adjustment without breaching PPE integrity.

After the gown and before eye protection and gloves. Placing the respirator after the gown but before other items allows proper fit and sealing without interference from eye protection or gloves.

Don a new set of PPE; do not reuse disposable PPE. Disposable PPE is single-use to prevent cross-contamination, requiring fresh items for each entry to maintain infection control standards.

Gown → mask/respirator → goggles/face shield → gloves. This order ensures the gown covers clothing first, followed by respiratory protection, eye coverage, and finally gloves to seal over gown cuffs, minimizing contamination risks.

Perform hand hygiene. Hand hygiene removes transient microorganisms from hands, preventing their transfer to PPE and subsequent patient contamination during care.

Gloves → goggles/face shield → gown → mask/respirator. This sequence starts with the most contaminated items to reduce self-contamination, ending with the mask to maintain respiratory protection until the end.

Gloves. Gloves are typically the most contaminated due to direct contact with patients and surfaces, so removing them first minimizes spreading pathogens to other PPE or skin.

Mask or respirator. Removing the mask last maintains respiratory protection during the doffing process when aerosolized particles may still be present.

Glove-in-glove removal (peel off, then slide fingers under cuff). This method contains contaminants inside the gloves by inverting them during removal, preventing contact with bare skin.

Unfasten ties, pull away from neck/shoulders, turn inside out, roll. This technique contains contaminants on the inside of the gown by turning it outward while rolling, avoiding contact with underlying clothing or skin.

Handle only the ties/ear loops; do not touch the front. The front is considered contaminated, so handling only clean ties or loops prevents transferring pathogens to hands.

Handle only the strap/arms; do not touch the front surface. The front surface is potentially contaminated from splashes, so touching only clean straps or arms avoids hand contamination.

Perform hand hygiene. Hand hygiene eliminates any residual microorganisms that may have transferred during doffing, reducing the risk of pathogen transmission.

Airborne precautions. Airborne precautions involve pathogens that remain suspended in air, requiring a respirator to filter small particles, unlike larger droplets blocked by surgical masks.

Surgical mask. Droplet precautions protect against large respiratory particles, which a surgical mask effectively blocks without needing the higher filtration of an N95.

Gown and gloves upon room entry. Contact precautions prevent transmission via direct touch or contaminated surfaces, necessitating barriers like gown and gloves for all room entries.

Surgical mask (plus eye protection if splash risk). Droplet precautions target large particles from coughs or sneezes, with a mask providing respiratory protection and eye wear added for potential fluid splashes.

Protect skin and clothing from contamination. Gowns act as a barrier against microorganisms and body fluids, preventing their adherence to underlying skin or clothing during close patient contact.