7 Essential Personal Protective Equipment (PPE): Donning, Doffing & Precautions

Learn about Personal Protective Equipment (PPE). Understand proper donning and doffing. Familiarize yourself with gowning and gloving. Follow standard precautions to ensure safety in healthcare settings.

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Personal Protective Equipment (PPE)

What is PPE?
Personal Protective Equipment (PPE) includes clothing and gear. Healthcare workers use them to protect themselves from infectious agents. These include bacteria and viruses. It acts as a barrier between the worker and harmful germs found in blood, body fluids, or contaminated surfaces.

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Why is PPE Important?

✅ Prevents the spread of infections.
✅ Protects healthcare workers from exposure to germs.
✅ Reduces the risk of contamination.

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Types of PPE

1. Gloves – Protect hands from direct contact with blood, body fluids, and contaminated surfaces.
2. Gowns/Coverall – Protects the body and clothing from splashes and spills.
3. Masks & Respirators – Prevent inhalation of infectious droplets.
   • Triple-layer mask: Protects from droplets.
   • N95 mask: Filters airborne particles and provides a tight facial seal.
4. Face Shield – Covers the face and prevents splashes into the eyes, nose, and mouth.
5. Goggles – Protects only the eyes from splashes and sprays.
6. Head Covers – Covers the head and hair to prevent contamination.
7. Shoe Covers – Prevents germs from spreading through footwear.

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Principles of Using PPE

✔ Wash hands before and after wearing PPE.
✔ Check PPE before use; replace if damaged.
✔ Use PPE properly to ensure full protection.
✔ Remove PPE immediately after patient contact.
✔ Never reuse disposable PPE.
✔ Store PPE safely to prevent contamination.

Donning and Doffing of Personal Protective Equipment (PPE)

Proper donning and doffing of personal protective equipment (PPE) is crucial to reducing the risk of exposure to pathogens. Effective use of PPE includes correctly wearing, removing, and disposing of contaminated equipment.

Donning PPE

PPE must be donned correctly and in the proper order before entering a patient care area. Modifications to PPE should not be made once inside the care area. Ensure you are hydrated and have used the restroom beforehand, as PPE may need to be worn for extended periods. Perform thorough hand hygiene before beginning.

Steps for Donning PPE:

1. Remove personal items – Remove home clothes, jewelry, watch, etc., and wear a clean hospital scrub suit.
2. Check PPE kit – Ensure all components are present: mask, gown, gloves, head cover, shoe cover, and face shield.
3. Perform hand hygiene – Use hand sanitizer or wash hands with soap and water.
4. Wear shoe covers – Sit comfortably and put on shoe covers.
5. Put on the first pair of gloves – Ensure proper fit.
6. Wear the gown. Make sure the sleeves cover the gloves. The gown should fully cover the body when tied or closed.
7. Put on the mask/respirator –
   • Hold the respirator in one hand and bring it to the face.
   • Pull the lower elastic band overhead and position it below the ears.
   • Pull the upper elastic band overhead and position it above the ears.
   • Pinch the nose clip to ensure a tight fit and check for a snug seal by exhaling three times.
8. Wear the face shield or goggles – Ensure full coverage of the face.
9. Wear the second pair of gloves – Gloves should go over the cuff of the gown.

Doffing PPE

Removing used PPE is a high-risk process that must follow a structured procedure to minimize self-contamination. A trained observer or doffing assistant and a designated removal area may be necessary.

Steps for Doffing PPE:

1. Sanitize gloves – Rub hands together while wearing gloves.
2. Remove shoe covers – Touch only the outer surface.
3. Remove the second pair of gloves – Dispose of them properly.
4. Remove the gown –
   • Grasp the front of the gown and slowly pull it away, breaking the ties at the back.
   • Pull the gown away from the body, rolling it into a bundle with the contaminated surface inside.
   • Discard it in the appropriate receptacle.
5. Remove the face shield –
   • Tilt the head forward, grasp the strap, and gently pull it overhead.
   • Remove the shield away from the face.
6. Remove goggles –
   • Grasp the earpieces behind the ears and pull them away from the face, avoiding contact with the front surface.
7. Remove the inner gloves – Perform hand hygiene and put on a new pair of sterile/unsterile gloves.
8. Remove the mask/respirator –
   • Gently pull the lower elastic band overhead, followed by the upper band, and remove the mask away from the face.
9. Remove the last pair of gloves – Perform thorough hand hygiene.

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Gowning

Definition:
Gowning is an essential procedure in maintaining a sterile environment during surgery. It prevents contamination and ensures patient safety.

General Guidelines:

• Only the scrub nurse should gown and glove herself.
• Other team members should be gowned and gloved as they enter the room.
• Once gowned and gloved, stay in the sterile area until the setup is complete.
• Hands should be kept above the waist and in front of the body.
• If the gown gets contaminated with blood or fluids, change it immediately.

Steps of Gowning:

1. Pick up the gown – Hold it from the inside top layer without touching unsterile areas.
2. Let the gown unfold – Step back and allow it to drop without touching anything.
3. Insert arms into sleeves – Keep hands at shoulder level while sliding arms into the sleeves.
4. Assistant helps fasten the gown – The assistant secures the gown at the back without touching the sterile side.

Removing the Gown:

1. If disposable, remove gloves along with the gown and roll them together.
2. If not breakaway, untie the waist first, then the neck.
3. Pull the gown away from the shoulders with ungloved hands.
4. Roll the gown into a bundle without touching the outer contaminated surface.

This ensures a sterile environment and prevents infection risks.

Gloving

Definition:
Gloves provide a protective barrier. They shield healthcare workers and patients from infectious microorganisms found in blood, body fluids, and waste. Double gloving (wearing two gloves) can further reduce contamination risk during major surgeries.

Steps for Putting on Surgical Gloves:

1. Prepare the gloves – After scrubbing, ask someone to open the glove package.
2. Pick up the first glove – Use the left hand to grasp the cuff of the right glove.
3. Wear the right glove – Insert the right hand and pull the glove on, keeping the cuff turned down.
4. Pick up the second glove. Use the fingers of the gloved right hand. Grasp the cuff of the left glove.
5. Wear the left glove – Insert the left hand. Pull the glove on. Ensure the cuff covers the gown sleeve.
6. Adjust the cuffs – Pull the cuffs properly over the gown sleeve to secure the gloves.

Steps for Removing Surgical Gloves:

1. Loosen the first glove – Grasp near the cuff and pull it partway off, turning it inside out.
2. Loosen the second glove – Keep the first glove partially on while removing the second one.
3. Remove both gloves together – Carefully pull off both gloves at the same time, touching only the inside surfaces.
4. Dispose of gloves properly – Avoid splashing contaminants and discard gloves immediately.
5. Wash hands thoroughly – Always clean hands after glove removal.

Proper gloving and removal help maintain sterility and prevent infections.

Standard Precautions:

Definition:
Standard precautions are measures for infection control. They are used to prevent the spread of diseases through blood, body fluids, non-intact skin, and mucous membranes. These precautions apply to all patients, reducing infection risks for both healthcare workers and patients.

Where to Use Standard Precautions?

Standard precautions should be used in any setting where there is exposure to:
✔ Blood
✔ Body fluids (semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, pleural fluid, etc.)
❌ Standard precautions are not required for feces, urine, vomit, sweat, saliva, nasal secretions, and sputum unless they contain visible blood.

Who Should Follow Standard Precautions?

✔ Doctors, nurses, and healthcare workers
✔ Support staff (housekeeping, laundry, etc.)

Standard Precaution Practices:

1. Hand Hygiene – Wash hands with soap and water or use an alcohol-based hand rub to prevent infections.
2. Personal Protective Equipment (PPE) – Wear gloves, masks, gowns, and goggles as needed to prevent exposure.
3. Respiratory Hygiene – Cover mouth and nose while coughing or sneezing; use tissues and masks to prevent droplet infections.
4. Sharps Safety – Dispose of needles and sharp objects properly to avoid injuries and transmission of bloodborne infections.
5. Safe Injection Practices – Use sterile syringes and needles only once to prevent infections.
6. Sterile Instruments and Devices – Clean, disinfect, and sterilize reusable medical instruments before use on another patient.
7. Clean and Disinfected Environment – Regularly clean and disinfect patient areas and equipment to prevent the spread of microorganisms.

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COURSES

GNM

BSC NURSING

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