General Approach: To Put On PPE (Donning)

Applying and Removing Personal Protective Equipment (Gloves, Gowns, Mask)
The type of PPE used will vary based on the level of precautions required, such as standard and contact,
droplet
or airborne infection isolation precautions. The procedure for putting on and removing PPE should be
tailored
to the specific type of PPE.
Combination of PPE required will affect sequence, be practical in your approach. Order of sequence
is adopted according to situation.
General Approach
Don PPE from bottom up
1. Boot covers/cap
2. Gown/Apron
3. Surgical Mask/Respirator(N95)
4. Goggles/Face Shield
5. Gloves (Double Gloving is option)
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.
Equipment
 Gown/Apron
 Simple Facemask/N-95
 Clean gloves (Double Gloving option)
Procedure
Sr.# STEPS RATIONALE
To Put on PPE (Donning)

1. Verify client identity and introduce
yourself, explain for the client what
you are to do, why it is necessary,
and how he or she can participate.
2. Perform hand hygiene.

3. Apply a clean gown:  Overlapping securely covers the uniform
a) Pick up a clean gown, and at the back, waist ties keep the gown
allow it to unfold in front of from falling away from the body, which
you without allowing it to can cause inadvertent soiling of the
touch any area soiled with uniform.
body substances.
b) Slide the arms and the hands
through the sleeves.
c) Fasten the ties at the neck to
keep the gown in place.
d) Overlap the gown at the back
as much as possible and
fasten the waist ties
4. Applying the face  To be effective the mask must cover both the nose and
mask/Respirator (N95): the mouth, because the air moves in and out of both.
a) Locate the top edge of
the mask; the mask
usually has a narrow
metal strip along the
edge.
b) Hold the mask by the
top two strings.
c) 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.
d) Secure the lower edge
of the mask under the
chin, and tie the lower  A sure fit prevents both the escape and the inhalation of
ties at the nape of the microorganisms around the edges of the mask.
neck.  Mask should be used only once because it becomes
e) If the mask has a ineffective when wet.
metal strip, adjust this
firmly over the bridge
of the nose
f) Wear the mask only
once
g) Do not let a used mask
hanging around the
neck.
5. Apply Goggles and Face To protect eyes and face from fluid /splash exposure
shield
Putting on eyes goggles
and face shield is an
option, depends on
direct exposure with
patient fluids, blood or
mucous splashes etc.
6. Apply clean gloves.
If wearing gowns pull
the gloves up to cover
the cuffs of the gown.
To remove soiled PPE (Doffing)

There are a variety of ways to safely remove PPE without contaminating your clothing, skin, or
mucous membranes with potentially infectious materials.
General Approach
Proper removal of PPE is a key to ensuring that you do not contaminate yourself.
Always remove from the dirtiest to the cleanest. Perform hand hygiene in each step (Before,
between and after) of removing PPE.
Doff PPE in alphabetical order (usually)
1. Boot covers (if worn)
2. Gloves(Double Gloving is option)
3. Goggles/Face Shield
4. Gown/Apron
5. Surgical Mask/ Respirator

6. Remove the gloves
first since they are the
most soiled. If wearing
gown that is tied in
front undo ties before
removing the gloves.
7. Perform hand hygiene.  Contact with microorganisms may occur.
8. Remove the
Goggles/Face Shield.
• Outside of goggles or
face shield are
contaminated!
• If your hands get
contaminated during
goggle or face shield
removal, immediately
wash your hands or
use an alcohol-based
hand sanitizer.
• Remove goggles or
face shield from the
back by lifting head
band or ear pieces.
• If the item is reusable,
place in designated
receptacle for
reprocessing.
Otherwise, discard in
a waste container.
9. Remove the gown
when preparing to
leave the room
a) Avoid touching soiled
parts on the outside of
the gown.
b) Grasp the gown along
the inside of the neck
and pull down over
the shoulders. Do not
shake the gown.
c) Roll up the gown with
the soiled part inside,
and discard it in the
appropriate container.
10. Remove the mask.  This prevents the top part of the mask from falling
a) Remove the mask at onto the chest.
the doorway to the
client’s room. If using
respirator mask,
remove it after leaving
the room and closing
the door.
b) If using mask with
strings, first untie the  The front of the mask through which the nurse has been
lower strings. breathing is contaminated.
c) Untie the top string
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.
d) Discard a disposable
mask in the waste
container.
e) Perform proper hand
hygiene again.
Images are from the © Centers for Disease Control and Prevention (CDC), 2011. Guidance for the Selection and
use of Personal Protective Equipment (PPE) in Healthcare Settings. Retrieved May 16, 2012 from
http://www.cdc.gov/HAI/prevent/ppe.html
APPENDIX- 1
APPENDIX- 2
APPENDIX-3

General Approach: To Put On PPE (Donning)

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Applying and Removing Personal Protective Equipment (Gloves, Gowns, Mask)

 To protect health care workers and clients from transmission of potentially

Sr.# STEPS RATIONALE

To Put on PPE (Donning)

2. Perform hand hygiene.

To remove soiled PPE (Doffing)

Doff PPE in alphabetical order (usually)

1. Boot covers (if worn)

2. Gloves(Double Gloving is option)

5. Surgical Mask/ Respirator

7. Perform hand hygiene.  Contact with microorganisms may occur.

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