Donning and Doffing of Personal Protective Equipment (PPE)


One of the most crucial parts of the infection control system is PPE (which stands for personal protective equipment). It keeps the patient, you and everyone around you away from infections and diseases. One of the most commonly used personal protective equipment is gloves. The gloves are disposable and are meant to be taken in use only once. They are composed on nitrile rubber or vinyl rubber and should be worn by a certified nursing assistant, whenever he has to touch body fluids or any infectious materials.

Another example of PPE is gowns. Gowns are composed of a very thin fabric, which is resistant to water. They are also meant to be used only once. After being worn once, they should be disposed properly. Whenever the CNA has to come in contact with a patient, who has been isolated to prevent infectious diseases from spreading or whenever he has to touch body fluids, a gown must be worn by him over his uniform.

For facial parts, like mouth, eyes and nose; personal protective equipments, like goggles and masks should be used. The goggles protect the eyes and the mask protects the mouth and nose. Parts like, eyes, mouth and nose are considered to be most vulnerable to germs and other infectious agents. In case, a person has to come in contact with body fluids or excessive bodily secretions, he must protect his face using the mask and goggles.

Steps to Follow for Putting on the Personal Protective Equipment (to be followed in the given order):

  1. First of all, you need to unfold the gown and wear it in a way that the opening of the gown comes at your back and the closed part comes in front. Put your hands inside the sleeves and tie the gown at the neck and waist (a little tightly so that it does not come off while performing a procedure on the patient).
  2. Next, apply the equipment provided for the protection of your face. The goggles should be comfortable and they should cover your eyes properly. However, they should not mess up with your vision. The mask provided for the face should fit properly on your nose and mouth.
  3. The gloves should be worn in the last step. When wearing, make sure that the cuffs cover your wrists properly and its end should go over the sleeves of the gown so that your skin does not remain exposed.

Steps to Follow for Removing the Personal Protective Equipment

When you are done with the patient and it is time to tale of your personal protective equipment, then make sure you take off the isolation gear before you move out from the room of the patient. Then follow the below mentioned steps to remove the PPE:

  1. First of all, remove the gloves. Use one hand to get hold of the external part of the gloves at the wrist of other hand. Pull out the gloves to remove it from your hand. Use your gloved hand’s fist to ball up the removed gloves. Lump and grasp the remaining part of the gloves in your hands and then pull off the gloves from other hand. You must remember to dispose the gloves properly in a receptacle.
  2. Remove the gown next. To take off the gown, pull it off from the neckline. In this way, the sleeves of the gown will come inside out. The gown should be balled properly and you must remember to dispose the gloves properly in a receptacle.
  3. Simply take off the face mask and dispose it in the trash container meant for it. You should remember to put the goggles for decontamination, after you remove it.
  4. After you have disposed all the personal protection equipments in the correct way, wash your hands properly as described in our washing hands skill demonstration part.

Correct use and disposal of personal protection equipments keep the patient, you and everyone around you away from infections and diseases. So, one must not neglect the related procedure.

What Does the Examiner See when You Perform this Skill?

Here’s a list of things that the examiner notices, when you are performing this skill:

  1. If you have done the things you were required to do in the beginning.
  2. If you have figured out the type of isolation you need.
  3. If you have used the required PPE before entering into the isolation room. For the mask “ If you have applied the face mask covering your mouth and nose in a proper way; Gown “ If you have worn the gown properly and tied it in the correct way, to cover your waist and neck; Gloves “ If you have worn the gloves correctly.
  4. If you removed the required PPE before leaving the isolation room. For the mask “ If you have taken the mask off in the correct way and washed your hands in an appropriate manner; For the glove “ If you have taken the gloves off in the correct way and washed your hands in an appropriate manner; For the gown “ If you have taken the gown off in the correct way and washed your hands in an appropriate manner.
  5. If you have disposed all the used personal protection equipments correctly in the receptacle.
  6. If you have done the things you were required to do in the end.

Few More Tips from Expert CNAs

For a large number of certified nursing assistants, personal protection equipment (PPE) simply means gloves. Because of this negligence, medical professionals often suffer from infections and diseases they catch in their work area. While practicing in the classroom, the importance of using PPE may not seem very high; but while dealing with a real patient, PPE may act as the thin line between you and your patient’s life and death! The best way to keep yourself on the correct track is to think that each and every patient is suffering from a horrible infection and you cannot afford to skip using the appropriate personal protection equipment. When you do this, you will see that the patient, you and everyone around is safe. This is called universal precautions.

When working with a patient who is in isolation, the use of personal protection equipment becomes really very important. You will never want the germs to put the patient into isolation and you won’t definitely want to give your own germs to a person, who is already having a very weak immune system.

It is important to use PPE but one must not get crazy about it. This may make the patient feel bad and offended. An expert CNA shared one of his most embarrassing situations with us. In the early days of his work, he was given charge of a patient, who was suffering from AIDS and was in its final stages. The CNA got so freaked out that he started wearing two gloves, two gowns and a full face mask. Though the patient did not say a word, but he feels that the patient must have felt very offended. It was not possible to continue in the same way, so the CNA went through counseling and finally got over his fear. So here, you learn a lesson that patients are human too and you must try to make them as comfortable as you possibly can.

Video Demonstration:

Here’s a video that demonstrates the perfect way to doff and don the personal protection equipments properly, during the skill demonstration. Have a look:

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