PPE — Donning & Doffing

The Two Rules

1. Don clean to contaminated — start from your skin outwards.
2. Doff most-to-least contaminated — gloves come off first, respirator last. Hand hygiene between every step.

---

Donning Steps

Donning — Putting PPE On

Perform in a clean area outside the procedure room. A trained observer should watch each step.

1

Remove personal items

Remove all jewellery, watch, phone, pens, ID tag. Secure spectacles around head. Put on scrub suit.

2

Hand hygiene

Use Alcohol-Based Hand Rub (ABHR); allow to dry.

3

Boots & boot covers

Sit on a chair to wear.

4

Hand hygiene

Use ABHR; allow to dry.

5

N95 respirator

Perform fit check. Adjust as necessary.

6

Inner gloves

Use different colours if possible to detect breaches.

7

Hood cover

Cover all hair, ears, neck, and shoulders. Hood before gown for better security.

8

Isolation gown

Impervious long-sleeved gown, length to mid-calf. Wrap around waist and tie at side. Observer may assist.

9

Outer apron

Impervious; covers front of body and legs.

10

Outer gloves

Pull cuffs over gown sleeve. Sterile gloves optional for better fit.

11

Face shield

Length must cover well below chin.

12

STOP & CHECK

Observer verifies PPE integrity. HCW performs range of motion. Do NOT enter if check fails.

Seal check is not optional

An N95 that leaks is no better than a surgical mask. If you cannot achieve a seal — beard, mask size mismatch, damaged respirator — do not enter the room. Swap the respirator or hand off the procedure.

Doffing Steps

Doffing — Taking PPE Off

Perform in a designated doffing area (anteroom or clearly marked zone). The outside surfaces of all PPE are contaminated — touch only the inside or straps.

Hand hygiene after every step

Perform hand hygiene (ABHR) after each and every doffing step before proceeding to the next. Only the first instance is shown in the visual guide below — apply it throughout the entire sequence.

1

General inspection

Wipe with EPA disinfectant if soiled. Change outer gloves if visibly soiled.

2

Remove outer apron

Tear from top; roll inside-out. Discard into clinical waste bin.

3

Hand hygiene

Use ABHR; allow to dry.

4

Remove outer gloves

Slip finger underneath; avoid touching outside. Discard. (Beaking method allowed)

5

Remove gown

Observer unties straps. HCW grasps inside at shoulders, pulls downward. Fold inside-out into bundle. Discard.

6

Remove face shield

Grasp straps from middle of head; bend forward. Eyes closed.

7

Remove hood cover

Grasp back from middle of head; bend forward. Eyes closed.

8

Remove boot covers

Sit on chair. Grasp inside, roll inside-out down to ankle. Avoid touching legs together. Discard.

9

Disinfect boots

Wipe outer layer and sole with EPA disinfectant wipes.

10

Remove inner gloves

Slip finger underneath; avoid touching hands. Discard. (Beaking method allowed)

11

Remove N95 respirator

Grasp straps from back of head; bend forward so mask slips away from face. Discard.

12

Hand hygiene

Use ABHR; allow to dry.

---

Critical Reminders

Never do this

• Don't touch your face at any point during the procedure or doffing.
• Don't reuse single-use PPE — gowns, gloves, and N95s are one-procedure items unless your facility has an extended-use protocol.
• Don't doff alone when possible — a trained observer catches mistakes.
• Don't shortcut hand hygiene between doffing steps. Most self-contamination happens here.

If anything tears or is breached mid-procedure

Stop the procedure if safe, exit to the doffing area, and re-don from step 1. Document the breach in the incident log per the Emergency & Exposure protocol.