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Difficulty: MediumAccident, Error, and Injury Prevention

A practical nurse (PN) has finished providing care for a client isolated with a highly contagious respiratory infection. The PN must now remove personal protective equipment (PPE) before leaving the client's room. Arrange the following steps for PPE removal in the correct sequence to minimize the risk of self-contamination and injury.

  1. 1Remove gloves by grasping the outside of one glove at the wrist, peeling it off, and holding it in the gloved hand to remove the second.
  2. 2Remove goggles or face shield by handling only the clean headband or ear pieces.
  3. 3Unfasten the gown ties, pull the gown away from the neck and shoulders touching the inside only, and roll it inside out into a bundle.
  4. 4Remove the mask or respirator by grasping the bottom ties or elastics, then the top, without touching the contaminated front.
  5. 5Perform thorough hand hygiene using an alcohol-based hand rub or soap and water.

Answer

The correct sequence for removing personal protective equipment is: remove gloves, remove goggles or face shield, remove gown, remove mask or respirator, and finally perform hand hygiene.
According to standard infection control protocols, PPE must be removed in a sequence that minimizes the risk of self-contamination. Gloves are considered the most contaminated and are removed first. The goggles or face shield are removed next by the clean straps. The gown is then carefully removed and rolled inside out. The mask is removed last to protect the respiratory system from particles that may have been disturbed during the removal of the other items. Hand hygiene is the mandatory final step to eliminate any transient flora acquired during the doffing process.

Step-by-Step Solution

1
Remove the gloves.
The most heavily contaminated items are removed from the hands.
Prevents the contaminated gloves from transferring pathogens to the face, hair, or clean areas of other PPE during removal.
2
Remove the goggles or face shield.
The mucous membranes of the eyes are safely uncovered.
Handling only the clean ear pieces or headbands with bare hands prevents self-contamination.
3
Remove the gown.
The body is freed from the contaminated gown without spreading pathogens.
Rolling the gown inside out traps pathogens inside the bundle, protecting the nurse's uniform and the environment.
4
Remove the mask or respirator.
Respiratory protection is safely removed.
The mask is removed last to ensure the respiratory tract remains protected from any airborne particles disturbed while taking off the other garments.
5
Perform hand hygiene.
Any residual pathogens on the hands are completely destroyed or washed away.
This is the essential final step to prevent cross-contamination and ensure the nurse's hands are clean before interacting with other clients or surfaces.

Key Concept

Accident, Error, and Injury Prevention: PPE Doffing Sequence
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Topics

Accident, Error, and Injury Prevention

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