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Standard/Transmission-Based Precautions/Surgical Asepsis

A nurse has just finished caring for a client in contact and droplet precautions. The nurse is preparing to doff personal protective equipment (PPE) before exiting the room. Place the following PPE removal steps in the correct CDC sequence from first (1) to last (5).

Ordered Response

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Remove the surgical mask or N95 respirator by handling only the ties or elastic, never the front
Perform hand hygiene with soap and water or alcohol-based hand rub
Remove the gloves by grasping the outside of one glove with the other gloved hand and peeling off
Untie the gown ties and pull the gown away from the neck and shoulders, rolling it inside out
Remove the goggles or face shield by handling the headband or earpieces, not the front
Explanation
CDC standard PPE doffing sequence prevents self-contamination by removing items in order from most contaminated to cleanest, with hand hygiene last. Step 1 — gloves: hands always touch contaminated surfaces, so gloves come off first using the outside-glove-to-outside-glove technique then bare-hand to inside-glove. Step 2 — goggles or face shield: front is contaminated, so handle only the headband or earpieces. Step 3 — gown: untie and pull away from neck and shoulders, rolling the contaminated outside inward. Step 4 — mask or N95: handle only the ties or elastic; the front filters contaminated air. Step 5 — hand hygiene: soap and water or alcohol-based rub before leaving the room. Hand hygiene is also performed between any contamination event during the sequence.
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For study reference only. Always follow current clinical guidelines and your institution’s protocols.