Steps for Doffing (Removing) Personal Protective Equipment (PPE) (Nursing)

00:04 Now let's talk about PPE removal.

00:07 If you recall, when we actually put this on, we're going to start putting on our gown.

00:13 Then we're going to put on our mask, then put on our goggles or face shield and then our gloves.

00:19 That's how we put on or don our PPE.

00:23 Now let's take a look at removal.

00:25 This is taking off our PPE.

00:28 Now if you take a look at these options, when we take it off, you notice the first step on either option A or B is taking off your gloves because these are going to be the most contaminated.

00:40 Next you see an option A, you can then remove your goggles or face shield, and then your gown.

00:46 And then, if you have a mask or respirator, you're going to remove this last.

00:50 Now with option B.

00:52 If you remember we started with those gloves.

00:54 Then we'll do our gown.

00:56 Then goggles or face shield and then our respirator last.

01:00 So one big note, I want to say is that there's going to be little variation on this.

01:06 The main piece you notice about both options is we always take our gloves off first.

01:11 Again, because these are the most contaminated.

01:14 And you notice here with both options that we always take our mask or respirator off last.

01:22 Now just keep in mind, anytime we're removing PPE, it's a good chance that we can become contaminated especially our hands upon removal.

01:32 So you need to always immediately wash your hands or use an alcohol-based hand sanitizer.

01:39 So you need to be wise and pick which one depending on the type of precautions that you were using with your patient.

01:46 And many times when we're talking about a contact precaution room, you really need to use good soap and water and wash your hands.

01:54 Now let's take a look at those options, option A and option B.

01:58 Now option A, when we start with this, of course, the first step is going to be removing your gloves.

02:04 Now it's important here that we do our best to try to put our finger inside the gloves not on the contaminated piece on the outside and pull away from the body and we're going to turn these inside out.

02:17 Then we're going to dispose of our gloves.

02:20 Now next with option A, you can choose here to remove your goggles or your face shield.

02:25 Now as you can imagine, the outside and the front of our goggles or our shield are contaminated.

02:32 So it's really key that we remove from the back if at all possible.

02:37 And step 3, now we can move on to our gown.

02:40 And you've always got to think about even if you can't visibly see anything on the outside of the gown.

02:45 It's always considered dirty or contaminated.

02:49 So take a look at this image here.

02:51 Notice that we're using the backside of the ties, then we're going to fold our gown inside.

02:57 So we're going to roll all of the outside into the inside, then we're going to dispose of this.

03:05 Now option B, if you remember that step 1 and 2, we always start with our gloves.

03:10 So we're going to remove our gloves and remove our gown.

03:13 And remember, gown or gloves doesn't really matter that the outside is always considered dirty or contaminated.

03:22 Now step 3, we're going to remove our goggles or face shield and again, remember that the outside of the goggles or the shield is contaminated and we're going to remove from the back.

03:33 Now notice this last step, this is where if it's indicated, we're going to remove our mask or our respirator here depending on the precaution.

03:44 This should be done outside of the room with the door closed.

03:49 This is an important point.

03:51 So we do not want to remove this inside the patient's room, we want to get outside of safety, close the patient's door, then we can remove our mask or respirator.

04:06 Now that we've completed our treatment with our patient, we can remove our PPE.

04:11 So the first thing we're going to do is remove our gloves.

04:14 They're going to be the most contaminated.

04:17 So when I start I'm going to pinch the middle of my glove and I'm going to pull it away from my body and I'm being really careful to roll the glove inside itself and inside the other glove.

04:32 And next once I've removed one glove, I like to take my thumb and put it inside the cuff of the other glove and slowly pull off as well.

04:42 And again as you can see, the glove turns inside out.

04:46 Then I can remove these and discard.

04:50 Now once I've removed my gloves, now we can remove our gown.

04:53 So if you remember the gown is considered contaminated and all of your PPE is considered contaminated.

05:00 So when you're removing, take caution of where your move it from.

05:03 Here's what I mean with my gown.

05:05 I don't want to grab here and pull.

05:07 It's most likely contaminated here on my chest.

05:10 So I'm going to grab up around my neck and most of these you can just snap and tearaway and I'm going to fold inside itself and roll it away from my body.

05:26 And when I do this, I'm going to tear here as well.

05:29 And then roll it inside itself and I'm going to discard my gown.

05:34 Now once I've removed my gown, I'm going to take off my goggles.

05:37 And notice, I'm not grabbing it here at the front, I'm grabbing it here towards the back.

05:43 I've removed my goggles.

05:45 Next, I can remove my face shield, and then my mask or my respirator.

05:50 Now anytime you're removing PPE, understand that we're touching contaminated objects.

05:56 And if it's soiled, we may need to perform hand hygiene after remove our gloves.

06:01 And it's also ideal after remove all of your PPE to wash your hands.