Donning and doffing PPE the mnemonic way

By: September 6th, 2011 Email This Post Print This Post

Do your employees find it difficult to remember the order in which they should put on and take off PPE?

The CDC recommended order for donning items is not the same as for doffing PPE used for protection from bloodborne pathogens or in isolation precautions settings.

Use the mnemonic tip suggested by Susan E. Sammons, RN, at Bacharach Institute for Rehabilitation in Pomona, NJ:

Don PPE from the bottom up:

  1. Gown
  2. Mask
  3. Goggles
  4. Gloves (when raised above the head)

Doff PPE in alphabetical order:

  1. Gloves
  2. Goggles
  3. Gown
  4. Mask

Staff members have responded positively to having a graphic/mnemonic reminder at each PPE dispensing station, says Sammons.

You can see a sample of the PPE dispenser posters and quick-recall wallet cards, which Sammons sells through RapidRecalling.com.

Also, check out the free PPE-related downlaods under the Bloodborne Pathogens and Personal Protective Equipment heading on the Tools page.

Do you have a favorite safety tip that you would like to share with your colleagues? Tell us about it through the Contact Us feature.

Comments

I cannot imagine doffing your gloves brfore the gown!! In the OR we take off the gown first and then the gloves. This prevents the stuff on the gowns from contacting your ungloved hands. Someone was not thinking

If the patient was in airborne precautions the mask would be the last PPE to doff. Otherwise, I would doff gloves last, to protect my hands from potential contamination of blood, etc. from removal of my gown. Then, always hand hygiene after removal of gloves.

By Cassandra Clark on September 6th, 2011 at 2:46 pm

I was a Surgical Tech instructor and I agree with the comment above. In the operating room this would be as follows for DON PPE 1. mask 2. Eye protection 3. Gown 4. Gloves

For Doff PPE 1. Gown 2. Gloves 3. goggles 4. mask. Of course this all depends on if any gross contamination is on the goggles then you would need to remove surgical gloves and put on utility ones to remove mask and goggles.

The 39 member Healthcare Infection Control Practices Advisory Committee (HICPAC)developed the evidence base research 2007 PPE sequence. The CDC poster includes imperative details of the HICPAC studies. My cousin is an epidemiologist Neuro Surgeon for WHO and the CDC. He never spends a moment “Not Thinking.” I can’t agree with the above comments as they divert from the evidence. Kudos to Mr LaHoda for standing behind the standard. Too many HAI’s result from antiquated practice.

By Ryan Sparta on September 9th, 2011 at 4:12 am

After researching this process I must admit that I found student nurses have prepared for the NCLEX using the alphabetical removal of soiled gowns and gloves.

Tell that 4 years later to the nurse with Ebola in Texas Neuro Surgeon

I too am a Surgical RN and agree with removing the gloves after the gown. I have researched alot of web sites and for the most part they talk about the sleeves being contaminated so when you take off the gloves first the contaminated gown is being pulled over your hands or when you reach up to remove your eye protection the dirty sleeves are near your face. Our facility is using the CDC’s guideline for PPE removal, I doesn’t make sense. I’m sticking with AORN guidelines.

By Lance lester md on October 14th, 2014 at 10:03 pm

Removing gloves first is absurd. The external contaminated sleeve contaminants the hands and wrist. Reaching behind the head with gown on to release gown exposes the patient to potential sleeve contaminants.

By Jackie Loveall, RNC on October 16th, 2014 at 1:58 pm

We are training now to wear two pair of gloves. First pair come off first then second pair gets removed last. Then wash hands.

By Ren Scott, MSN/Ed, RN, CNOR on October 22nd, 2014 at 1:28 pm

AORN (Association of periOperative Registered Nurses) does not advocate removal of the gloves first, as gowns in surgery are considered contaminated.

The CDC distributed a revised donning/doffing of PPE poster about a week ago that includes a 3rd page with ‘Example 2′– which demonstrates removal of the gown and gloves simultaneously. You can find the revised poster at http://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf

 

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