Guidance on Personal Protective Equipment (PPE) Sequences

The correct sequence for donning (putting on) and doffing (removing) Personal Protective Equipment is essential to ensure the safety of healthcare workers and prevent the spread of infectious agents. Following these steps systematically minimizes the risk of self-contamination.

Sequence for Donning PPE

The goal of donning is to create a secure barrier before entering a hazardous environment. Follow this order:

1. Gown: Fully cover your torso from neck to knees, arms to the end of the wrists, and wrap around the back. Fasten securely at the back of the neck and waist.
2. Mask or Respirator: Secure ties or elastic bands at the middle of the head and neck. Fit the flexible band to the nose bridge. Perform a seal check if using a respirator.
3. Goggles or Face Shield: Place over the face and eyes and adjust to fit.
4. Gloves: Extend to cover the wrist of the isolation gown.

Sequence for Doffing PPE

The doffing process is the most high-risk moment for contamination. Treat all outer surfaces of PPE as if they are contaminated. Follow this order:

1. Gloves: The outside of the gloves is contaminated. Grasp the outside of the glove with the opposite gloved hand and peel off. Hold the removed glove in the remaining gloved hand. Slide fingers of the un-gloved hand under the remaining glove at the wrist and peel off, creating a bag for the first glove. Discard.
2. Gown: Unfasten ties, taking care that sleeves do not contact the body when reaching for ties. Pull the gown away from the neck and shoulders, touching only the inside of the gown. Turn the gown inside out and roll into a bundle. Discard.
3. Hand Hygiene: Perform hand hygiene immediately after removing the gown.
4. Goggles or Face Shield: Remove from the back by lifting the head band or ear pieces. Do not touch the front of the goggles or face shield. Discard or place in a designated reprocessing area.
5. Mask or Respirator: Do not touch the front of the mask. Grasp the bottom ties or elastics, then the top ties or elastics, and remove without touching the face. Discard.
6. Hand Hygiene: Perform hand hygiene again immediately after removing all PPE.

Safety Best Practices

• Always perform doffing in a designated area.
• Never touch your face, hair, or skin during the removal process.
• If at any point you suspect you have become contaminated, stop the process, perform hand hygiene, and contact your supervisor.
• PPE should be discarded in appropriate waste receptacles as per facility protocols.