Lesson 5 - Part 6
Donning and Doffing PPE
Understanding the proper procedures for donning and doffing personal protective equipment (PPE) is crucial. The sequence for donning PPE is determined by the specific type of equipment being worn, while the sequence for doffing PPE is determined by the level of contamination. In this lesson, you will gain insight into the detailed steps for donning and doffing PPE, as well as the optimal location for performing these activities.
ALL THE LINKS TO VIDEOS MENTIONED ARE IN THE PANEL TO THE RIGHT
FAQ's
You can minimize the spread of contaminated if you take off your PPE is a specific order. Remove the most contaminated first and the least contaminated last.
What you do with your used personal protective equipment (PPE) depends on the type of equipment being used. Certain PPE, such as disposable gloves, are intended for single use and must be discarded in a biohazardous waste bin after use. Other types of PPE can be cleaned with an appropriate disinfectant and reused multiple times. It is important to be knowledgeable about the specific type of PPE being used and understand the proper procedures for disposal or cleaning after each use.
PPE should be donned and doffed at the transition zone between the “clean” and “contaminated” areas of your facility. This is often at the doorway to the working area or in an anteroom.
Now let’s look at the sequence for donning and doffing PPE. Since you often wear more than one piece of PPE, what is the preferred order of donning? In some cases, the order is dictated by the physical requirement for one type of PPE to overlap another. But in general, the preferred order for donning PPE is gown first, then mask or respirator, then goggles or face shield and last gloves. Remember this is just a general guideline and the combination of PPE may affect the sequence; therefore, you must be practical.
Watch this short video to see an example for donning of one set of PPE (https://www.youtube.com/watch?v=YAr31WmHbVU).
Doffing, or the order of which you take off PPE, has a specific sequence and that order is important, because the PPE is probably contaminated. When thinking about the order of how you should take off your PPE, it is helpful to think about what areas of the PPE that might be contaminated or clean. Typically, the contaminated area of the PPE is mainly the outside and front. The clean areas are usually the inside of the PPE and back, which are areas not likely to have been in contact with the infectious organisms.
Taking into consideration the clean and dirty areas, you want to remove the PPE in the order that causes the least spread of contamination. In general, the order is gloves first, since these are likely the most contaminated. Then the face shield or goggles by touching only the back or inside. Then the gown by touching only the straps at the back or the inside. If it is a disposable gown, you may turn it inside out. Finally, the mask or respirator, which could be removed inside/outside the room. If you think there is an infectious aerosol hazard in the room, then remove the respirator outside the room. Again, these are only general guidelines and the exact order should be dictated by the PPE you wear and the risk assessment.
Watch this short video to see an example for doffing of one set of PPE (https://www.youtube.com/watch?v=wLuYDv65_to).
Where in your facility is the best place to remove this contaminated PPE? There is no one perfect or correct answer, because it will depend very much upon your local situation. But in general, you want to remove the PPE at the transition zone between what you consider a dirty, or contaminated space, and a clean space. This is usually at the doorway, before leaving the patient or laboratory room or in the anteroom. Anterooms are gray zones, which are neither clean nor dirty, found between the procedure room and the outside. Where ever you choose to doff the PPE, ensure that hand hygiene facilities are available at that point. This is preferably a sink with running water, soap, and towels.
Reusable PPE, such as googles, should be wiped with a suitable disinfectant, and placed in storage for reuse. Disposable PPE should go into the regular biohazardous trash for autoclaving. Cloth PPE, such as coveralls, can be washed and reused after sterilization.
Next, we will conclude this module on PPE with a summary and application exercise.