August 27, 2020
Amidst the COVID-19 pandemic, healthcare professionals must be educated in the correct donning and doffing of personal protective equipment (PPE), particularly removal and disposal of contaminated PPE. While providing care, this is a highly important exercise that limits exposure to pathogens for infection control and prevention for healthcare professionals themselves and their patients.
What is PPE?
PPE refers to equipment used in the workplace to minimize exposure to hazards that may cause illness or injury. In healthcare, it protects the wearer from injury and the spread of illness or infection. All PPE should be safely designed, constructed, and maintained. The type of PPE used will vary dependent upon the level of precautions required. In hospitals, dental offices, or clinical labs, individuals should apply both standard and transmission-based precautions. When properly used, PPE acts as a barrier between the wearer’s skin, mouth, eyes, and nose and infections materials transmitted through respiratory secretions, body fluids, and blood. Some PPE equipment might include:
• Gowns
• Aprons
• Head coverings
• Shoe coverings
• Gloves
• Masks
• Face shields
• Goggles
Effectively using PPE
For the effective use of PPE, all healthcare workers should be informed about infections and updates on policies, protocols, and procedures in their organization. Workers also need access to the necessary equipment to carry out their tasks safely and correctly. Effective use of PPE includes properly donning as well as doffing and disposing of contaminated equipment.
Sequence for Donning PPE
The following is a sequence to accurately don PPE:
1. Perform Hand Hygiene
• Handwashing with soap and water involves wetting hands, applying the appropriate amount of soap, applying the product to all surfaces of hands with a minimum 15 second contact time, and rinsing all surfaces with water, and drying with single-use towel.
• Use alcohol-based hand sanitizer by applying the appropriate amount of product to hands, applying product to all surfaces with a minimum 15 second contact time, and rub hands until dry.
2. Put on Gown
• The gown should cover the torso fully from neck to knees and from the arms to the end of the wrists.
• It should wrap around the back and fasten in the back around the waist and neck.
3. Put on Mask or Respirator
• Secure the ties in the middle of the neck and head or around the ears.
• Fit flexible band tight to the bridge of the nose.
• Fit mask securely to the face and below the chin.
• Fit check equipment according to manufacturer instructions.
4. Put on Eye protection
• Place face shield or goggles over eyes, secure around the back of the head, and adjust fit.
5. Put on Gloves
• Extend gloves to cover the wrist of the gown.
• Add a second pair for added protection.
Sequence for Doffing PPE
When removing PPE, consider all pieces contaminated. The proper doffing of PPE should protect mucous membranes, skin, and clothing from contamination. This is the sequence to accurately doff PPE:
1. Remove Gloves and Gown
• Outside of gloves are contaminated and the front and sleeves of gown are contaminated.
• Pull the gown away from the front using only gloved hands to break the ties.
• As the gown pulls away, peel off gloves at the same time, touching only the inside in the process.
• Turn gown inside out and fold and roll the gown into a bundle and deposit in the proper waste receptacle.
2. Perform Hand Hygiene (as listed above)
3. Remove Eye Protection
• Front of goggles and face shields are contaminated.
• Remove eye protection or face shield from the back of the head.
• If disposable, discard in the proper waste receptacle.
• If reusable, deposited in designated processing receptacle.
4. Perform Hand Hygiene
5. Remove Mask or Respirator
• Front of mask or respirator is contaminated.
• Grasp bottom and then top ties to remove.
• Discard in the proper waste receptacle.