PPE Sequencing & Hand Hygiene

Donning

Gown first, tied at neck and waist. Then the mask or respirator, secured over the nose and under the chin, with a fit check for an N95. Then goggles or a face shield. Gloves go on last, pulled over the gown cuffs so no wrist is exposed.

Doffing

Gloves come off first because they are the most contaminated surface in the room. Goggles come off next, handled by the headband. The gown is then pulled away from the body, rolled inward and discarded. The mask comes off last, by the ties or elastics, and only after you have left the room — except for a respirator worn for airborne precautions, which is removed outside the room with the door closed behind you.

The five moments

Hand hygiene is expected before touching a client, before a clean or aseptic procedure, after body-fluid exposure risk, after touching a client, and after touching the client's surroundings.

• Alcohol-based rub — 20 to 30 seconds, all surfaces, until dry
• Soap and water — at least 20 seconds, required for visible soil, C. difficile and norovirus
• Gloves are never a substitute for hand hygiene