Donning and Doffing a level 4 PPE

Materials needed:
Surgical cap Coverall
Shoe covers 2 sets of gloves
N95 respirator/Surgical mask Alcohol-based handrub/handrub
Face shield

Putting on (Donning)

Steps Rationale

1. Prepare all necessary materials and Ensure all materials are complete and
ensure completeness of materials. sizes are appropriate before you start
donning. This is to avoid interruption
in the middle of donning.

2. Remove personal clothing and items Before starting the donning procedure,
change into clean surgical scrubs. No
personal items (e.g., jewelry, watches,
cell phones, pagers, pens) should be
brought into patient room/sterile area
to prevent .

3. Secure hair. Put on surgical cap. To provide an extra layer of protection

aside from the hood of coverall.

Visually inspect the PPE and check if

4. Inspect PPE prior to donning supplies are available, and that the
sizes selected are correct for the
healthcare worker. To ensure that it is
 in good condition and there are no
tears in the PPE.

5. Put on boot covers This is to protect your lower

extremities from coming into contact
with any bodily fluids from the patient.

Make sure that all areas of the foot are

covered and the boot covers are snug
over your ankle and calf. If your boot
covers have a strap, wrap the strap
around for a comfortable fit. Try not to
touch the floor or other areas with
your hands while putting the boot
covers on. If you do, disinfect your
hands before putting your inner gloves
on.

6. Perform hand hygiene using To prevent possible transmission of

handrub. infection from the care provider to the
client.

7. Put on inner gloves Put on the first pair of gloves.

Cuffs of inner gloves should be tucked
under the sleeves of coverall.

8. Put on coverall suit To protect your entire body from

coming into contact with the patient’s
bodily fluids/secretions.
9. Make thumb holes at the border of To allow thumb to be inserted through
sleeves of the coverall. the sleeves of the coverall.

10. Put on N95 mask. Ensure that the size fits and covers
your nose and mouth well.

12. Perform seal check on the mask To ensure that there is no space that
would allow air to pass through inside
the mask.

13. Lift hood of coverall to the head. Ensure the hood covers the surgical
cap, ears and neck with no skin
exposed.

12. Put on outer gloves Ensure cuffs are pulled over the
sleeves of coverall.

13. Put on face shield To protect your facial area especially

the eyes from being exposed.
Taking off (Doffing)

Materials:
High risk zone and low risk zone label Wipes
Infectious waste bag Chair
Hand rub

Steps Rationale
1. Locate the high risk zone and low risk There should be a designated area
zone. for removal of PPE. This is to
contain the possible transmission
of infection from the PPE, it is
assumed that the PPE is “dirty.”

2. Place all PPE in a leak-proof bag To contain all contaminated

designated for infectious waste. materials.

3. Inspect PPE for visible contamination or To ensure if no skin/part of body

tear. was exposed during patient
care/encounter.

4. Disinfect outer gloves using hand rub. To prevent spread of infection.

(Assume a spotter is with you)

5. Remove boot covers using hands-free To prevent any contact of gloved

approach. Touch only the inner surface of hands to boot covers.
boot covers.

6. Perform hand hygiene/hand rub. To prevent spread of infection.

7. Remove outer gloves. Ensure not to To prevent any contact of
contaminate the inner gloves when contaminated gloved hands to
removing the outer gloves. clean inner gloves.

8. Inspect inner gloves for any

contamination or tear and disinfect.
(If with contamination or tear, disinfect
and remove glands. Do hand hygiene on
bare hands then put on a new pair of
gloves).

9. Remove face shield. Avoid touching the To prevent any contact from the
front surface. gloved hands to the contaminated
face shield.

1. Disinfect inner gloves. To prevent spread of infection.

10. Remove hood. Grasp the back of the To prevent any contact from the
hood carefully by pulling it backwards. gloved hands to the contaminated
hood.

11. Disinfect inner gloves. To prevent spread of infection.

12. Remove coverall. Avoid contact with To prevent any contact from the
outer surface of the coverall. contaminated coverall.

Find the zip from the level of your belly.

Carefully trace the zipper and unzip
completely before rolling down and
turning inside-out.
Avoid contact with the outer surface,
touch the inside of the coverall only
especially when disposing.

13. Disinfect inner gloves. To prevent spread of infection.

14. Perform handy hygiene on bare hands To prevent spread of infection.

and allow to completely dry.

15. Put on a new pair of gloves. To prevent spread of infection by

using a new pair of gloves.

16. Remove the N95 respirator.

Tilt head forward and grab the straps. To prevent any contact from the
Remove the mask without touching the gloved hands to the contaminated
front surface. mask.

17. Disinfect gloves. To prevent spread of infection.

18. Disinfect shoes. To prevent spread of infection.

Be mindful of the high and low risk zone.

19. Disinfect and remove gloves. To prevent spread of infection.

20. Perform hand hygiene on bare hands. To prevent spread of infection.

21. Inspect scrub suit and skin for any To ensure that your scrub suit and
contamination. any part of the skin is not
contaminated.