Never touch the front of the gown, mask, or goggles during removal; it is considered contaminated.
Before you read
Test yourself first: 5 questions
Question 1 of 5
Which describes correct use of personal protective equipment for a client with C. difficile?
Answer: A. C. diff requires contact precautions (gown + gloves), dedicated equipment, and hand hygiene with soap and water (alcohol does not kill spores).
Question 2 of 5
Which is correct safe handling of a client's belongings and the environment to prevent infection?
Answer: B. Use dedicated/disposable equipment for clients on isolation, disinfect shared equipment between clients, and follow proper waste segregation. Sharing un-cleaned equipment spreads organisms.
Question 3 of 5
A nurse is preparing to remove personal protective equipment (PPE) after caring for a client in contact precautions. Which item should the nurse remove first?
Answer: B. Per CDC sequence, the most contaminated items are removed first while still in the room: gloves, then goggles/face shield, then gown, then mask/respirator (removed last, outside the room). Removing gloves first prevents spreading contamination from the dirtiest item to the hands and face.
Question 4 of 5
A nurse is donning personal protective equipment (PPE) to enter the room of a client on contact and droplet precautions. In what order should the PPE be applied?
Answer: C. The correct sequence for donning PPE is gown first, then mask or respirator, then goggles or face shield, and finally gloves. Gloves are last so they cover the gown cuffs.
Question 5 of 5
When removing personal protective equipment (PPE), which item is removed FIRST?
Answer: B. Doff most-contaminated first: gloves, then goggles/face shield, gown, and finally the mask/respirator (removed last, outside the room). Hand hygiene after.
Keep the streak going with more questions like these, each with a full rationale.
What is personal protective equipment sequence?
The donning order is gown, mask/respirator, goggles/face shield, then gloves. Doffing removes the dirtiest items first while protecting the face: gloves, goggles, gown, then mask last. Hand hygiene bookends the process.
Key points to remember
- Don in this order: gown first, then mask or respirator, then goggles or face shield, then gloves last.
- Gloves go on last during donning so they overlap and seal the gown cuffs.
- Doff in this order: gloves, then goggles or face shield, then gown, then mask or respirator last.
- Gloves are removed first when doffing because they are the most contaminated.
- The mask or respirator comes off last and is removed outside the room to protect the airway.
- Hand hygiene is performed before donning and again immediately after all PPE is removed.
Nursing priorities
- Perform hand hygiene before starting to don PPE.
- Apply gown, mask, eyewear, then gloves, ensuring gloves cover the gown cuffs.
- Remove gloves and gown together inside the room and discard them properly.
- Remove the respirator outside the room, then perform hand hygiene immediately.
Patient teaching
- Visitors are taught the same order so they do not contaminate themselves on the way out.
- Reinforce washing hands immediately after the last piece of PPE is removed.
Red flags: report now
- Never touch the front of the gown, mask, or goggles during removal; it is considered contaminated.
- Do not remove the mask or respirator inside an airborne-isolation room.
- Report any PPE breach or self-contamination so exposure can be evaluated.
References
Clinical references for this topic
