Personal protective equipment (PPE) is one of the most essential skills you will practice as a student in healthcare or laboratory settings. Knowing what to wear, in what order, and how to remove everything safely can reduce exposure to harmful substances and infections. This guide walks you through the selection, order, and safe removal of PPE, with practical examples and step-by-step instructions.
Why Correct PPE Use Matters
PPE is your last line of defense, not the first. Engineering controls and good work practices come first, but PPE keeps you safe when hazards remain. The way you put it on and take it off can mean the difference between staying protected and exposing yourself or others.
- Prevents contact with blood, body fluids, and contaminated surfaces.
- Reduces the risk of respiratory exposure to droplets and airborne particles.
- Protects your skin and clothing from hazardous chemicals and infectious agents.
- Helps prevent the spread of pathogens to vulnerable people around you.
PPE is only effective when it is worn correctly, removed correctly, and changed when needed.
Selecting the Right PPE for the Task
Selection starts with a risk assessment. Look at the task, the patient or specimen, the environment, and the likely route of exposure. The correct PPE matches the hazard you actually face.
Assess the Hazard
- Ask what type of exposure you expect: splashes, sprays, airborne particles, direct contact, or chemical spills.
- Choose PPE based on the specific hazard, not just the maximum available.
- For example, a simple paper mask is not enough for a procedure that generates aerosols; you need a respirator.
PPE Types and Their Role
- Gloves: protect hands from contamination and chemicals. Use nitrile for most tasks and heavy-duty gloves for sharp or chemical hazards.
- Gowns or aprons: protect skin and clothing. Choose fluid-resistant gowns if there is a splash risk.
- Surgical masks: block large droplets but are not tightly sealed. They protect your nose and mouth but do not filter small airborne particles.
- Respirators (N95 or higher): protect from airborne particles and require fit testing before use.
- Eye protection: goggles or safety glasses shield your eyes. Face shields protect the entire face and neck from splashes.
Checking Fit and Condition
- Gloves should fit snugly without tears; check for visible holes before each use.
- Gowns should cover your torso and tie securely at the neck and waist.
- Respirators must pass a fit check: cover your face, exhale, and feel for leaks around the edges.
- If any PPE is damaged, stained, or expired, do not use it. Replace it immediately.
The correct PPE can fail if it is the wrong size, the wrong material, or the wrong type for the task.
Order of Putting On PPE (Donning)
Donning must be done systematically to avoid contaminating your skin or clothing. Although the sequence can vary slightly by facility, the following order is widely taught and easy to remember.
Recommended Sequence
- Gown: cover your clothing and tie securely at the neck and waist.
- Mask or respirator: place over your nose and mouth, and adjust the nose piece to create a seal.
- Eye protection: put on goggles or a face shield, and adjust for comfort and visibility.
- Gloves: pull gloves over the cuff of the gown so no skin is exposed.
| Step | PPE item | Why this order |
|---|---|---|
| 1 | Gown | Protects your clothing and skin before you add anything else. |
| 2 | Mask or respirator | Covers your airway before you touch other items. |
| 3 | Eye protection | Shields your eyes from splashes that may happen during close work. |
| 4 | Gloves | Last step keeps your gloves clean for the task. |
Safe Removal of PPE (Doffing)
Removal is the highest-risk moment. PPE may be contaminated, so the goal is to touch only the least contaminated areas and avoid touching your skin or clothing. Always follow facility-specific doffing protocols, but the principles below are universal.
Key Principles
- Assume the outside of all PPE is contaminated.
- Remove PPE in a sequence that protects your skin and clothing.
- Perform hand hygiene immediately after removing each item, or at least after all items are removed.
- If possible, remove PPE inside a designated doffing area or near a waste bin.
Step-by-Step Removal
- Remove gloves: grasp the outside of one glove at the wrist, peel it off, and hold it in the other gloved hand. Then slide two bare fingers under the second glove and peel it off, turning it inside out without touching the outside.
- Perform hand hygiene.
- Remove eye protection: handle it by the sides, frame, or ear loops. Avoid touching the front of the goggles or shield.
- Remove gown: untie or break the ties, pull the gown from your shoulders, and peel it away from your body. Roll it into a ball with the contaminated outer side inward.
- Perform hand hygiene again.
- Remove mask or respirator: lean slightly forward, grasp the bottom strap or ear loop first, then the top strap. Pull it away from your face without touching the front.
Common Mistakes to Avoid
- Touching your face while wearing PPE.
- Reusing single-use PPE, such as non-sterile gloves or plastic aprons.
- Wearing the same gloves for more than one clean task.
- Removing gloves by pulling on the fingertips, which can cause splashes or tears.
- Leaving wrist cuffs or hair exposed when a gown or mask is required.
- Removing a respirator from the front or letting it snap back into your face.
- Skipping hand hygiene between doffing steps.
Practical Tips for Students During Training
- Practice donning and doffing in a skills lab until the sequence feels automatic.
- Ask a classmate or instructor to watch your technique and give feedback.
- Use a mirror or record a practice video to spot mistakes you do not notice.
- Always check that the right size and type of PPE are available before you start a procedure.
- Learn the color coding and signage used at your training site for PPE zones.
- If you are ever unsure, ask for help. It is better to pause and get confirmation than to risk exposure.
PPE is simple in principle but requires consistent practice. The selection, order, and safe removal of personal protective equipment are not just procedural steps. They are habits that protect you, your patients, and everyone around you. Master these skills now, and you will carry them into every clinical or laboratory setting you enter.
Frequently Asked Questions
What is the correct order for donning PPE?
The common order is gown first, then mask or respirator, then eye protection, then gloves. This sequence keeps your skin covered before you put on gloves and prevents contamination during the process.
What is the correct order for doffing PPE?
A widely used order is gloves first, then hand hygiene, then eye protection, then gown, then mask, followed by a final hand hygiene step. The key is to remove the most contaminated items first and clean your hands between steps.
Can I reuse a respirator?
Reuse depends on the type and the facility policy. In many healthcare settings, N95 respirators can be reused for extended periods if they remain clean, undamaged, and not contaminated with blood or body fluids. Always follow local guidelines and your instructors’ advice.
How often should I change gloves?
Gloves are single-use. You should change them when they are torn, visibly dirty, or after each interaction with a patient or a contaminated item. Never wash and reuse single-use gloves.
What is the difference between a surgical mask and an N95 respirator?
A surgical mask is a loose-fitting barrier that blocks large droplets. An N95 respirator is a tight-fitting device that filters at least 95% of airborne particles. N95s must be fit-tested, while surgical masks can be used by any person without fit testing.
Do I need a face shield if I wear safety glasses?
Safety glasses protect only your eyes. A face shield also covers your face, nose, mouth, and neck, making it safer for procedures with splashing or spraying. If you only need eye protection from splashes, goggles are enough. For full-face protection, use a shield.
How can I tell if a gown is fluid-resistant?
Check the labeling and packaging. Fluid-resistant gowns are usually marked with a barrier performance rating or described as “fluid-resistant” or “impermeable.” They are made of materials such as polypropylene or laminated fabric that prevents liquids from soaking through.
Should I perform hand hygiene before or after PPE removal?
You should perform hand hygiene both before donning and after doffing. If possible, also clean your hands between doffing steps, especially after removing gloves and after removing the gown.
What should I do if I touch a contaminated part of my face?
Stop what you are doing, remove your PPE carefully, and clean the area with soap and water or an alcohol-based hand rub if there are no visible body fluids. Report the exposure to your supervisor or instructor immediately, especially if it involves blood or bodily fluids.
How do I know if my PPE is too large or too small?
PPE should fit without gaps or excessive tightness. For gloves, the fingers should move easily without stretching, and the cuff should cover your wrist. For gowns, the sleeves should reach your wrists and the back should close completely. For respirators, you should not feel air leaking around the edges. If any item does not fit, stop and get the correct size.
