A practical nurse is completing care for a client diagnosed with norovirus and seasonal influenza. The nurse is wearing an isolation gown, clean gloves, a surgical mask, and a face shield. Arrange the steps for doffing the personal protective equipment (PPE) and performing hand hygiene in the correct chronological order.
- 1Grasp the outside of one glove at the palm and peel it off, then slide an ungloved finger under the remaining glove to remove it.
- 2Remove the face shield by handling only the clean headband or earpieces.
- 3Unfasten the gown ties, pull the gown away from the neck and shoulders touching only the inside, and roll it into a bundle.
- 4Remove the surgical mask by grasping the bottom ties or elastics, followed by the top ties, without touching the front.
- 5Perform meticulous hand hygiene using soap and water.
Answer
The correct sequence for doffing PPE is to remove the gloves first, followed by the face shield, then the isolation gown, then the surgical mask, and finally perform hand hygiene using soap and water.
According to standard Centers for Disease Control and Prevention (CDC) guidelines for doffing personal protective equipment, the items considered most contaminated should be removed first. Gloves are removed first, followed by eyewear such as a face shield or goggles. The gown is removed next, taking care to roll it inside out. The mask is removed last to protect the respiratory tract during the doffing of other items. Finally, hand hygiene must be performed; in the case of norovirus, soap and water must be used instead of alcohol-based hand rub.
Step-by-Step Solution
Key Concept
Standard and Transmission-Based Precautions (PPE Doffing Sequence)