DONNING &

DOFFING
Personal
Protective
Equipment
August 2012
CHRISTINE TAUSCHKE
ICP
 produced for

Infecton Prevention & Control

Information Day – Aged Residential
Care
GrampiansRegional Infection Control Group

Powerpoint utilses information from

NSW Heath
www.health.nsw.gov.au/resources/quality/hai/tool_protective_ppt.asp
Department of Health and Human Service - USA
Guidance for the Selection and Use of Personal
Protective Equipment (PPE) in Healthcare Settings
CDC Centre Disease Control
DONNING AND DOFFING PPE

♦ IS IT PROTECTING
US FROM THE
STICKY STUFF ?

♦ Not Really.. It can

but smell is not my
concern it’s ……
Much More than that
 DONNING AND DOFFING PPE

♦ IS IT ABOUT PROTECTING
US FROM
THE SHARP
STUFF ?

Not Really.. It can help

( eye wear) but that is not
why we don & doff PPE it’s
Much More than that
THERE
ARE

TECHNIQUES
and
EQUIPMENT
GLOVE USE
♦ Used when contact with
– body fluids anticipated.
♦ Single use and MUST BE
– discarded after patient contact
♦ HAND HYGIENE
– after removal ALWAYS
 GOWNS
♦ SHORT
♦ LONG
♦ PLASTIC

What are
we doing?
DEPENDS ON
PURPOSE
MASKS
♦ SINGLE USE
♦ WHY - splash
body fluids is anticipated
♦ N95/ P 2 for
– AIRBORNE diseases
♦ Replace when moist
♦ Dispose of directly
into waste
♦ http://www.bing.com/videos/search?q=Danger+Zone+Song&qpvt=Danger+Zone+Song&FORM=VDRE
Can’t ask the ill to stop coughing
PRECAUTION SIGNAGE
BLOOD & BODY FLUID SPILLS
PERSONAL PROTECTIVE EQUIPMENT
 MY Aims
& Objectives
♦ Ensure HCW workers are aware of
the correct sequence for
(DONNING) PPE
♦ Ensure HCW are aware of the
correct sequence for removing PPE
in a manner that prevents self-
contamination and self-inoculation
( DOFFING)
DOFFING ??????
♦ Doffing, Texas
for every100 96.9
Performed by hand - doffing your gear

♦.
 Personal Protective Equipment
(PPE)
♦ PPE refers to whatever protective equipment may
be used to insulate an individual from the hazards
presented by the environment in which he or she is
working.
♦ In the healthcare environment it refers to specialised
clothing or equipment worn by an employee or
patient for protection against infectious materials
and other contaminants. ( or VISITOR)
♦ The type of PPE used will vary based on the level
of precautions required; such as, Standard, Contact,
Droplet or Airborne Infection Isolation
21
Some important things to
remember about PPE
♦ Don PPE before contact with patient, generally
before entering the room.
♦ Keep gloved hands away from the face and avoid
touching or adjusting PPE.
♦ Remove and discard PPE carefully. This should
be done at the doorway (just prior to leaving
patient’s room) or immediately outside patient
room. Surgical or particulate masks should be
removed outside room.
♦ Immediately perform hand hygiene using soap
and water or an alcohol-based gel or rub
25
Sequence for Donning PPE

1. Gown/apron
2. Surgical or particulate
mask
3. Protective Eye wear
4. Gloves

26
Step 1 Perform hand hygiene
♦ Perform hand hygiene before
putting on Personal Protective
Equipment (PPE)
♦ With soap and water, or
♦ Alcohol based gel / rub

BEFORE
27
Step 2 Gown/Apron
♦ Fully cover torso from
neck to knee, arms to end
of wrist, and wrap around
the back.

♦ Fasten at back of neck

and waist.

28
Step 3 Surgical mask or
particulate (P2 or N95)
♦ Secure ties or elastic bands
at middle of head and neck
♦ Fit flexible band to nose bridge
♦ Fit snug to face and below chin
♦ Fit check particulate
♦ (P2 or N95) only

29
Step 3 continued,
Fit Checking P2 or N95 Masks
• Gently inhale. When you
breathe in the mask should
Observe for air leakage
draw in lightly toward the face around edges of mask
and collapse
§ Gently exhale.
§ The mask should fill up with
air.
It is important at this stage that
there is no air leakage around the
edges of the mask

30
Step 3 continued,
Fit Checking P2 or N95 Masks
If you have not achieved a successful fit check
as instructed it is important that you seek
advice or have someone assist you with
fitting and checking your mask.

An incorrectly fitted mask will not provide you

with the intended level of protection from
airborne infectious diseases 31
Step 4 Protective Eyewear
Place goggles or face shield
/visor over face and eyes
and secure using the
ear pieces or headband

Adjust to
fit comfortably

32
Step 5 Gloves

♦ Don gloves last

♦ Select correct size& type
♦ Insert hands into gloves
♦ Extend to cover wrist
of gown

33
You are now ready
and safe to enter
the patient’s room
PHEWW….

34
 Safe use of PPE
♦ Keep gloved hands away from face
♦ Avoid touching or adjusting other PPE
♦ Change gloves when torn or heavily
contaminated
♦ Limit surfaces and items touched to
prevent accidental contamination
Sequence for Removing PPE
1. Gloves
2. Face shields or goggles
3. Gown
4. Mask or respirator

36
 Sequence for Removing PPE

ted
a
in
tam contaminated
n
co

37
Sequence for Removing PPE
It is important to remember that the
sequence for removing PPE is
intended to limit opportunities for self
contamination and self inoculation
♦ Important to identify what sites or
areas are considered “clean” and what
are “contaminated”

38
Where to remove PPE
♦ At the doorway, before leaving the
patient’s room or in the anteroom if
available
♦ It is important to remove mask/ respirator
outside room, after the door to patient’s
room has been closed
♦ Hand washing facilities ( soap and water-
free skin cleanser) should be readily
available after all PPE is removed
39
Step 1 Gloves

♦ Outside of gloves is contaminated

♦ Grasp outside of glove with opposite
gloved hand; peel off
♦ Hold removed glove in gloved hand
♦ Slide fingers of ungloved hand under
remaining glove at wrist
♦ Peel glove off over first glove
♦ Discard gloves into waste container

40
 Step 2 Hand hygiene

♦ Perform hand hygiene following removal of

gloves
♦ Using soap and water, or
alcohol based gel / rub

41
Step 3 Protective Eyewear
Outside of goggles or face shield
IS CONTAMINATED
To remove, handle by head band
or ear pieces
Place reusable eyewear in
designated receptacle for cleaning
Or
discard disposable eyewear into waste
container for disposal

42
Step 4 Gown
/apron

♦ Gown front and sleeves are contaminated

♦ Unfasten ties at neck and waist
♦ Pull away from neck or
shoulders, touching inside
of gown only
♦ Turn gown inside out
♦ Fold or roll slowly into a bundle and
discard into designated waste container
43
 Step 5 Surgical or particulate
mask (P2 or N95)

♦ Front of mask is contaminated

♦ Remove by touching tapes or ties only

♦ Discard in designated waste container

Remove mask when outside patient’s room

44
Step 6 Hand Hygiene

♦ Perform hand hygiene following

removal of all Personal Protective
Equipment (PPE),
♦ Using soap and water, or
alcohol based gel / rub

45
DON - DOFF THE ORDER ????
Use the mnemonic tip suggested by Susan E. Sammons, RN,
at Bacharach Institute for Rehabilitation in Pomona, NJ:
Don PPE from the BOTTOM UP:
Gown
Mask
Goggles
Gloves (when raised above the head)

Doff PPE in ALPHABETICAL order:

Gloves
Goggles
Gown
Mask
PPE for Additional
(Transmission Based)
Precautions
♦ Airborne Precautions
- Particulate (P2 or N95) mask
♦ Droplet Precautions
– Surgical masks within 1 metre of patient and
protective eyewear
♦ Contact Precautions
– Gown/apron and gloves for contact with
patient or environment e.g. equipment and
surfaces in the patient’s environment
48
Q 1 Gowns and masks should be
removed by touching tapes or ties
only. The reason for this is:

a. The front of the mask or gown is

considered contaminated
b. Risk of tearing the mask or gown
c. You no longer need the mask or gown
d. So you cannot see what you are doing
e. You will ruin your make-up if
removal is performed from the front
49
Q2.Please nominate the correct
sequence for DONNING -
PPE

a. Gloves, gown, mask, eye protection

b. Gown, mask, eyes protection, gloves
c. Mask, Eye protection, gown, gloves
d. Eye protection, gown, gloves, mask

50
Q 3. Masks removal ( DOFFING IT )
should occur once outside the
patient’s room.
This is because……..

a. It is important to remain unidentifiable to the

patient for as long as possible.
b. Because the garbage bin allocated for mask
removal is located outside the room
c. Removing the mask inside the room would put
the HCW at unnecessary risk of exposure to
respiratory/airborne infection
51
Q4 Which of the following
statements are NOT true about
DONNING & DOFFING
a. It involves safe work practices and protective
barriers
b. DONNING
GOWN – MASK….. EYEWEAR then GLOVES
c. DOFFING
GLOVES then EYEWEAR ….GOWN – MASK…..
d. When I DOF, Hand Hygiene is only
performed last ( the after moment )
52