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3.3 PPE Donning and Doffing Sequences

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NCLEX-RN Registered Nurse

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1 Introduction

About the NCLEX-RN Exam Next Generation NCLEX (NGN) Clinical Judgment Measurement Model (NCJMM) How to Use This Course

2 Chapter 2: Management of Care

2.1 Legal Rights and Responsibilities 2.2 Advance Directives and Self-Determination 2.3 Informed Consent Protocols 2.4 Client Advocacy and Rights (HIPAA) 2.5 Assignment, Delegation, and Supervision 2.6 Five Rights of Delegation 2.7 Scope of Practice (RN vs LPN vs UAP) 2.8 Ethical Practice Principles

3 Chapter 3: Safety and Infection Prevention and Control

3.1 Standard Precautions and Hand Hygiene 3.2 Transmission-Based Precautions (Contact, Droplet, Airborne) 3.3 PPE Donning and Doffing Sequences 3.4 Fall Prevention and Restraints 3.5 Fire Safety (RACE/PASS) 3.6 Disaster Triage and Emergency Response

4 Chapter 4: Health Promotion and Maintenance

4.1 Growth and Development (Erikson/Piaget) 4.2 Developmental Stages: Infancy through Older Adult 4.3 Maternal and Newborn Care (Antepartum) 4.4 Intrapartum Care and Fetal Monitoring 4.5 Postpartum Care (BUBBLE-HE) 4.6 Health Screening Guidelines 4.7 Immunization Schedules

5 Chapter 5: Psychosocial Integrity

5.1 Therapeutic Communication Techniques 5.2 Non-Therapeutic Communication (What to Avoid) 5.3 Anxiety Disorders and Mental Health Concepts 5.4 Schizophrenia: Hallucinations and Delusions 5.5 Depression and Suicide Assessment 5.6 Substance Misuse and Withdrawal 5.7 Grief and End-of-Life Care

6 Chapter 6: Basic Care and Comfort

6.1 Mobility and Hazards of Immobility 6.2 Assistive Devices (Crutches, Canes, Walkers) 6.3 Nutrition and Diet Therapy 6.4 Enteral Nutrition (Tube Feeding) 6.5 Bowel Elimination and Ostomy Care 6.6 Urinary Elimination and Catheter Care

7 Chapter 7: Pharmacological and Parenteral Therapies

7.1 Medication Administration Rights 7.2 Medication Calculations 7.3 High-Alert Medications: Insulins 7.4 High-Alert Medications: Anticoagulants 7.5 High-Alert Medications: Opioids 7.6 High-Alert Medications: Digoxin and Electrolytes 7.7 IV Therapy and Complications 7.8 Blood Product Administration 7.9 Total Parenteral Nutrition (TPN)

8 Chapter 8: Reduction of Risk Potential

8.1 Laboratory Values: Hematology (CBC) 8.2 Laboratory Values: Metabolic Panel (BMP) 8.3 Laboratory Values: Coagulation Studies 8.4 Vital Signs and Trend Recognition 8.5 Perioperative Care (Pre-Op and Post-Op) 8.6 Nasogastric Tubes and Therapeutic Procedures

9 Chapter 9: Physiological Adaptation

9.1 Fluid Imbalances (Hypovolemia and Hypervolemia) 9.2 Arterial Blood Gases (ABGs) and Acid-Base Balance 9.3 Medical Emergencies: Stroke (CVA) 9.4 Medical Emergencies: Myocardial Infarction (MONA) 9.5 Diabetic Emergencies (Hypoglycemia and DKA) 9.6 Respiratory Conditions (COPD, Pneumonia) 9.7 Cardiac Conditions (Heart Failure) 9.8 Neurological Conditions (Seizures)

3.3 PPE Donning and Doffing Sequences

Key Takeaways Explain This Topic AI

Donning sequence: Hand hygiene, Gown, Mask/Respirator, Eye Protection, Gloves (inside to outside, clean to contaminated)

Doffing sequence: Gloves, Eye Protection, Gown, Mask/Respirator, Hand Hygiene (outside to inside, contaminated to clean)

Gloves are removed FIRST during doffing because they are the most contaminated item

The mask/respirator is removed LAST during doffing to protect the airway as long as possible

  • Hand hygiene must be performed immediately after removing all PPE and may be needed between PPE removal steps
  • Last updated: October 2026

Correct PPE sequencing is a high-priority topic on the NCLEX. The order matters because improper technique leads to self-contamination, defeating the purpose of wearing PPE.

The Logic Behind the Sequences

Donning (putting on): Start with items closest to your body and work outward. You put on clean items before touching potentially contaminated surfaces.

Doffing (taking off): Remove the most contaminated items first while keeping your face protected longest. The gloves touch everything contaminated; the mask protects your airway.

Donning Sequence: Putting ON PPE

Remember: "Go Get My Eyewear, Gloves" or work from inside to outside.

  • Step Action Rationale
  • 1 Hand Hygiene Start with clean hands
  • 2 Gown Goes on first; covers body/clothing
  • 3 Mask or Respirator Protect airway; secure snugly
  • 4 Goggles or Face Shield Protect eyes and face
  • 5 Gloves Go on last; cover gown cuffs
  • Detailed Donning Steps
  • Hand Hygiene
  • Use alcohol-based hand rub or soap and water
  • Ensure hands are completely dry before proceeding
  • Gown
  • Select appropriate size
  • Opening in the back
  • Secure at neck and waist
  • Gown should fully cover torso
  • Mask/Respirator
  • For surgical mask: secure ties or ear loops
  • For N95: perform seal check (positive and negative pressure tests)
  • Mask should cover nose, mouth, and chin
  • Eye Protection
  • Place goggles or face shield over face and eyes
  • Adjust to fit securely
  • Gloves
  • Select appropriate size
  • Insert hands into gloves
  • Extend glove cuffs OVER gown cuffs (no exposed skin)
  • Doffing Sequence: Taking OFF PPE

Remember: "Gloves, Eyes, Gown, Mask" or work from outside to inside (contaminated to clean).

  • Step Action Rationale
  • 1 Gloves Most contaminated; remove first
  • 2 Goggles/Face Shield May be contaminated from splashes
  • 3 Gown Remove carefully; avoid contact with outside
  • 4 Mask/Respirator Protects airway; removed last
  • 5 Hand Hygiene Final decontamination
  • Detailed Doffing Steps
  • Remove Gloves
  • Grasp outside of one glove with opposite gloved hand
  • Peel off, turning inside out
  • Hold removed glove in gloved hand
  • Slide fingers of ungloved hand under remaining glove at wrist
  • Peel off, turning inside out over first glove
  • Dispose in waste container
  • Perform hand hygiene
  • Remove Goggles/Face Shield
  • Handle by headband or earpieces (considered "clean")
  • Do NOT touch front of goggles
  • Place in designated area for reprocessing or dispose
  • Remove Gown
  • Untie ties (or break if ties are in back)
  • Pull gown away from neck and shoulders
  • Turn inside out
  • Fold or roll into a bundle
  • Dispose in waste container
  • Perform hand hygiene
  • Remove Mask/Respirator
  • Do NOT touch the front of the mask
  • For surgical mask: untie bottom tie first, then top; remove by ties
  • For N95: remove bottom strap first, then top strap
  • Dispose in waste container
  • Perform hand hygiene
  • Critical Safety Points
  • Gloves First During Doffing

Gloves are the most heavily contaminated PPE item. They touch:

  • The patient
  • Contaminated surfaces
  • Body fluids and secretions

Removing gloves first prevents contaminating other PPE or your face during the rest of the doffing process.

Mask Last During Doffing

The mask protects your respiratory tract-your most vulnerable entry point for pathogens. Keeping it on until last provides maximum airway protection throughout doffing.

For Airborne Precautions

The mask/respirator is removed outside the room after closing the door. This is because airborne particles remain suspended in the room air.

Common Doffing Errors

  • Error Consequence
  • Removing mask before gloves Face contamination
  • Touching front of mask during removal Hand contamination
  • Snapping gloves off Aerosolization of pathogens
  • Not performing hand hygiene between steps Cross-contamination
  • Pulling gown off over head Head/face contamination
  • PPE Based on Precaution Type
  • Precaution Donning Order Doffing Order
  • Contact Hand hygiene, Gown, Gloves Gloves, Gown, Hand hygiene

Droplet Hand hygiene, Mask on room entry (add gown, eye protection or gloves only when Standard Precautions call for them) Any gloves, eye protection and gown, then Mask, Hand hygiene

Airborne Hand hygiene, fit-tested N95 respirator (add gown, eye protection or gloves only when Standard Precautions or another precaution call for them) Any gloves, eye protection and gown, Hand hygiene, Exit room, N95 removal, Hand hygiene

Practice Scenario

A nurse is preparing to enter the room of a patient on contact and droplet precautions.

Donning sequence:

  • Hand hygiene
  • Gown
  • Surgical mask
  • Goggles
  • Gloves

Doffing sequence (inside room):

  • Gloves (dispose, hand hygiene)
  • Goggles (to reprocessing)
  • Gown (dispose, hand hygiene)
  • Mask (dispose)
  • Hand hygiene
  • On the NCLEX

Expect questions asking:

Which PPE item is removed first/last?

What is the correct sequence for donning/doffing?

Why is the mask removed last?

Where is the N95 removed for airborne precautions?

Exam Strategy: Visualize actually putting on and taking off PPE. The sequence makes logical sense once you think about contamination levels.

Loading diagram... PPE Donning and Doffing Sequences