Business Category: Health / Industrial Category: Health Care

PPE Donning and Doffing Sequence Checklist

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This comprehensive checklist provides healthcare personnel with step-by-step guidance for the correct donning and doffing of personal protective equipment (PPE), encompassing gowns, masks or respirators, goggles or face shields, and gloves. It details essential safe work practices to minimize contamination risk, presents two validated doffing method examples, and emphasizes the critical importance of hand hygiene throughout the process. Use this tool to standardize PPE protocols, safeguard healthcare workers and patients, and ensure consistent infection prevention across all clinical environments.

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PPE Donning and Doffing Sequence Checklist
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How to Use This Checklist

  • Start with your hands clean. Complete hand hygiene before you begin. Do not start the donning sequence with unclean hands or with any item already compromised.
  • Don the isolation gown first. Make sure it fully covers your torso from neck to knees and your arms to the end of your wrists, and that it wraps around your back. Fasten it securely at the back of the neck and waist.
  • Don the mask or respirator. Secure the ties or elastic bands at the middle of the head and neck, fit the flexible band snugly against the nose bridge, and check that the mask or respirator fits snugly and extends below your chin. Where a user seal check applies, perform one to verify a proper airtight fit.
  • Don the goggles or face shield. Place them over your face and eyes and adjust for a secure, comfortable fit.
  • Don the examination gloves last. Extend them to fully cover the wrist of the isolation gown, so no wrist skin is left exposed.

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What PPE donning and doffing is

PPE is the equipment you wear to protect yourself and the people around you from contact with infectious material. Donning means putting it on in a sequence that keeps each layer properly positioned for the one above it. Doffing means taking it off in a sequence that is built around contamination, so that a surface you have touched with a patient does not end up touching your skin. This checklist covers an isolation gown, a mask or respirator, goggles or a face shield, and examination gloves. On the way in, the order is gown, mask or respirator, goggles or face shield, then gloves. On the way out, the order runs the other way around, with hand hygiene throughout.

Why the sequence matters

Each step is designed so that you handle the surfaces you know to be contaminated with something that is not, and then dispose of that something. The checklist asks you to recognise the contaminated zones as you get to them: the outside of your gloves, the outside of your goggles or face shield, the front and sleeves of your gown, and the front of your mask or respirator. Getting the order wrong defeats the purpose of wearing PPE in the first place. If your hands become contaminated partway through a removal step, wash them immediately or use an alcohol-based hand sanitiser.

Donning sequence in detail

The checklist opens by asking you to select the items you are donning during this procedure. From there: 1. **Isolation gown.** Confirm it fully covers the torso from neck to knees and the arms to the end of the wrists, and wraps around the back. Fasten it securely at the back of the neck and waist. 2. **Mask or respirator.** Secure the ties or elastic bands at the middle of the head and neck and fit the flexible band snugly against the nose bridge. Make sure the mask or respirator fits snugly to the face and extends below the chin. Where a user seal check applies, perform one to verify a proper airtight fit. 3. **Goggles or face shield.** Place them over the face and eyes and adjust for a secure, comfortable fit. 4. **Gloves.** Extend the gloves so they fully cover the wrist of the isolation gown.

During patient care

Once you are fully dressed, the checklist asks you to keep your hands away from your face at all times and to limit the number of surfaces you touch in the patient care area. Change your gloves immediately when they are torn or heavily contaminated, and perform hand hygiene between patient encounters and whenever otherwise indicated.

Safely removing PPE — Example 1

The first method removes each item in turn. The checklist asks you to recognise the contaminated surface before you touch it, and to wash or sanitise immediately if your hands become contaminated during a step.

Safely removing PPE — Example 2

The combined method removes the gown and gloves together. Grasp the gown in the front and pull it away from the body so that the ties break, touching the outside of the gown only with gloved hands. While removing the gown, fold or roll it inside-out into a bundle and peel off your gloves at the same time, touching only the inside of the gloves and gown with your bare hands. Place the gown and gloves into a waste container, then continue with goggles or face shield, mask or respirator, and hand hygiene.

Frequently Asked Questions

Any care setting where you may contact blood, body fluids, or other potentially infectious materials, or where you follow isolation precautions. Whether your workplace falls under OSHA's requirements depends on your jurisdiction and setting, so check the rules that apply to you.

There is no set number. Don a gown, then a mask or respirator, then goggles or a face shield, then gloves, adding only the items your task and the precautions in place require. Select which items you are donning at the start of the procedure.

The checklist sets out two doffing methods: a step-by-step sequence that removes gloves, then goggles or a face shield, then the gown, then the mask or respirator; and a combined method in which you remove the gown and gloves together. Use one method consistently rather than switching between them.

Hand hygiene is built into the process. Clean your hands between patient encounters and whenever otherwise indicated, and wash or use an alcohol-based hand sanitizer immediately after removing all PPE. The checklist also reminds you to wash or sanitize immediately if your hands become contaminated partway through a removal step.

The doffing steps are built around the contaminated zones: the outside of your gloves, the outside of your goggles or face shield, the front and sleeves of your gown, and the front of your mask or respirator. The steps tell you which surfaces to touch and which to avoid, such as lifting goggles or a face shield by the head band from the back and unfastening gown ties without letting the sleeves contact your body.

The checklist includes fields to record the date, who prepared it, and the location, plus the PPE types used. After the donning sequence, you can record the time in minutes, rate overall quality and compliance, and document challenges, difficulties, or deviations. After doffing, you can rate quality and compliance.
Arne Reis
Written by
Arne Reis
Founder

Process optimizer with 25 years of expertise, focused on operational excellence in quality, maintenance, EHS, and commissioning. Emphasizes innovative solutions and top-quality standards.

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