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Difficulty: MediumStandard and Transmission-Based Precautions

A practical nurse is preparing to perform open tracheostomy suctioning for a client whose sputum is positive for methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates contact with copious respiratory secretions. Arrange the following steps for donning the required personal protective equipment (PPE) in the correct sequence.

  1. 1Perform hand hygiene using an alcohol-based hand rub or soap and water.
  2. 2Put on the isolation gown and secure the ties at the neck and waist.
  3. 3Apply a surgical mask and adjust the flexible band to fit the bridge of the nose.
  4. 4Place goggles or a face shield over the eyes and face.
  5. 5Don clean gloves and extend them over the cuffs of the isolation gown.

Answer

The correct sequence for donning PPE is: 1. Perform hand hygiene, 2. Put on the isolation gown, 3. Apply a surgical mask, 4. Place goggles or a face shield, 5. Don clean gloves.
The Centers for Disease Control and Prevention (CDC) guidelines mandate a specific sequence for donning PPE to maximize protection and prevent contamination. Hand hygiene is always the required first step. The gown is applied first as it is the largest barrier and requires reaching behind the neck and waist. The mask is applied second to secure respiratory protection. Eye protection is added third, resting over the upper edge of the mask. Gloves are applied last so they can be extended over the gown cuffs to seal the wrist area.

Step-by-Step Solution

1
Perform hand hygiene.
Hands are clean before touching PPE.
Prevents the transfer of pathogens to the clean protective equipment.
2
Don the isolation gown.
The torso and arms are protected.
The gown is the bulkiest item and requires tying at the back, which should be done before hand dexterity is reduced by gloves.
3
Apply the surgical mask.
The nose and mouth are protected from droplet splashes.
The mask must be fitted properly to the face before eye protection is added.
4
Place goggles or a face shield.
The eyes are protected from potential secretion splashes.
Eye protection rests over the mask to ensure complete coverage without compromising the mask's fit.
5
Don clean gloves.
The hands and wrists are fully protected.
Pulling gloves over the gown cuffs ensures there is no exposed skin at the wrists.

Key Concept

Standardized Sequence for Donning Personal Protective Equipment (PPE)
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Topics

Standard and Transmission-Based Precautions

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