Steps in PPE

PPE
PURPOSE
• To protect health care workers and clients from transmission of potentially infective materials
ASSESSMENT
 Consider which activities will be required while the nurse is in the client’s room at this
time. Rationale: This will determine which equipment is required.
PLANNING
• Application and removal of PPE can be time consuming. Prioritize care and arrange for
personnel to care for your other clients if indicated.
• Determine which supplies are present within the client’s room and which must be brought to
the room.
• Consider if special handling is indicated for removal of any speci- mens or other materials
from the room.
Equipment
 As indicated according to which activities will be performed, ensure that extra supplies
are easily available.
• Gown
• Mask
• Eyewear
• Clean gloves
IMPLEMENTATION
Preparation
 Remove or secure all loose items such as name tags or jewelry.
Performance
 Prior to performing the procedure, introduce self and verify the
client’s identity using agency protocol. Explain to the client what you are going to do, why it is
necessary, and how he or she can participate.
 Perform Hand Hygiene
 Apply a clean gown.

• Pick up a clean gown, and allow it to unfold in front of you without allowing it to touch any
area soiled with body substances.
• Slide the arms and the hands through the sleeves.
• Fasten the ties at the neck to keep the gown in place.
• Overlap the gown at the back as much as possible, and
fasten the waist ties or belt. ❶ Rationale: Overlapping securely covers the uniform at the
back. Waist ties keep the gown from falling away from the body, which can cause
inadvertent soiling of the uniform.
 Apply the face mask.
• Locate the top edge of the mask. The mask usually has a
narrow metal strip along the edge.
• Hold the mask by the top two strings or loops.
• Place the upper edge of the mask over the bridge of the
nose, and tie the upper ties at the back of the head or secure the loops around the ears. If glasses
are worn, t the upper edge of the mask under the glasses. Rationale: With the edge of the
mask under the glasses, clouding of the glasses is less likely to occur.
• Secure the lower edge of the mask under the chin, and tie the lower ties at the nape of the
neck. ❷ Rationale: To be effective, a mask must cover both the nose and the mouth, because
air moves in and out of both.
• If the mask has a metal strip, adjust this firmly over the bridge of the nose. Rationale: A secure
to prevents both the escape and the inhalation of microorganisms around the edges of the mask
and the fogging of eyeglasses.
• Wear the mask only once, and do not wear any mask longer than the manufacturer
recommends or once it becomes wet. Rationale: A mask should be used only once because it
becomes ineffective when moist.
• Do not leave a used face mask hanging around the neck.
• The Practice Guidelines provide further instructions on
applying a face mask.
 Apply protective eyewear if it is not combined with the face

mask.
 Apply clean gloves.

• No special technique is required.
• If wearing a gown, pull the gloves up to cover the cuffs of
the gown. If not wearing a gown, pull the gloves up to cover
the wrists.
 To remove soiled PPE, remove the gloves first since they are
the most soiled.
•If wearing a gown that is tied at the waist in front, undo the
ties before removing gloves.
 Remove the first glove by grasping it on its palmar surface,

taking care to touch only glove to glove. ❸ Rationale: This keeps the soiled parts of the used
gloves from touching the skin of the wrist or hand.
• Pull the first glove completely off by inverting or rolling the glove inside out.
• Continue to hold the inverted removed glove by the fingers of the remaining gloved hand.
Place the first two fingers
of the bare hand inside the cuff of the second glove.
❹ Rationale: Touching the outside of the second soiled glove with the bare hand is avoided.
 Pull the second glove off to the fingers by turning it inside out. This pulls the first glove
inside the second glove. Rationale: The soiled part of the glove is folded to the inside to
reduce the chance of transferring any microorganisms by direct contact.
 Using the bare hand, continue to remove the gloves, which are now inside out, and
dispose of them in the refuse container. ❺
 Perform hand hygiene. Rationale: Contact with microorganisms may occur while
removing PPE.
 Remove protective eyewear and dispose of properly or place in the appropriate

receptacle for cleaning.
 Remove the gown when preparing to leave the room.

• Avoid touching soiled parts on the outside of the gown, if possible. Rationale: The top part of
the gown may be
soiled, for example, if you have been holding an infant with a respiratory infection.
• Grasp the gown along the inside of the neck and pull down over the shoulders. Do not shake
the gown.
• Roll up the gown with the soiled part inside, and discard it in the appropriate container.
 Remove the mask.

• Remove the mask at the doorway to the client’s room. If
using a respirator mask, remove it after leaving the room
and closing the door.
• If using a mask with strings, first untie the lower strings of
the mask. Rationale: This prevents the top part of the mask
from falling onto the chest.
• Untie the top strings and, while holding the ties securely, remove the mask from the face. If
side loops are present, lift the side loops up and away from the ears and face. Do not touch the
front of the mask. Rationale: The front of the mask through which the nurse has been breathing
is con- taminated.
 Discard a disposable mask in the waste container.
 Perform proper hand hygiene again.

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Steps in PPE

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PPE

 Perform Hand Hygiene

 Apply a clean gown.

 Apply protective eyewear if it is not combined with the face

 Apply clean gloves.

 Remove the first glove by grasping it on its palmar surface,

 Remove protective eyewear and dispose of properly or place in the appropriate

 Remove the gown when preparing to leave the room.

 Remove the mask.

 Discard a disposable mask in the waste container.

 Perform proper hand hygiene again.

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