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Difficulty: MediumStandard and Transmission-Based Precautions

A nurse is preparing to enter the room of a client placed on airborne and contact precautions. The nurse has gathered the necessary personal protective equipment (PPE). In what order should the nurse don the PPE? Arrange the steps in the correct sequence from first to last.

  1. 1Perform hand hygiene using an alcohol-based hand rub or soap and water.
  2. 2Don the isolation gown and tie securely at the neck and waist.
  3. 3Apply the N95 respirator and perform a user seal check.
  4. 4Place the face shield or goggles over the eyes and adjust to fit.
  5. 5Don clean gloves and extend them over the cuffs of the gown.

Answer

The correct sequence is: 1. Perform hand hygiene, 2. Don the isolation gown, 3. Apply the N95 respirator, 4. Place the face shield or goggles, and 5. Don clean gloves.
The Centers for Disease Control and Prevention (CDC) guidelines establish a specific sequence for donning personal protective equipment (PPE) to maximize protection and minimize the risk of cross-contamination. Hand hygiene is universally performed first. The isolation gown is applied next because it provides foundational body coverage. The N95 respirator is applied and seal-checked before eyewear so the straps do not interfere with the goggles. Eye protection follows. Finally, gloves are donned last so they can be pulled securely over the gown's cuffs, establishing a continuous protective barrier.

Step-by-Step Solution

1
Identify the first priority before handling clean PPE.
Perform hand hygiene.
Hand hygiene removes existing pathogens from the hands and ensures the clean PPE remains uncontaminated during the donning process.
2
Select the piece of PPE that provides core body coverage.
Don the isolation gown.
The gown covers the torso and arms and must be tied securely behind the neck and waist to prevent shifting during patient care.
3
Apply respiratory protection.
Apply the N95 respirator.
The respirator must be fitted directly to the face before applying eye protection to ensure the straps are positioned correctly and the seal is completely intact.
4
Apply eye protection.
Place the face shield or goggles.
Eye protection sits over or adjacent to the respirator, providing droplet and splash protection for the mucous membranes of the eyes without interfering with the respirator.
5
Apply the final barrier.
Don clean gloves.
Gloves are placed last so they can be stretched over the edges of the gown cuffs, sealing the wrists and completing the continuous barrier.

Key Concept

Personal Protective Equipment (PPE) Donning Sequence
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Topics

Standard and Transmission-Based Precautions

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