A nurse is preparing to provide care for a patient on contact precautions for an MRSA wound infection. Which actions demonstrate correct personal protective equipment (PPE) technique? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Before entering, perform hand hygiene and don the gown, mask or respirator when indicated, eye protection, and gloves last so the gloves cover the gown cuffs (Choice 2). For the listed doffing method, remove gloves first, then eye protection and gown, remove the mask after leaving the room when appropriate for the isolation type, and perform hand hygiene (Choice 5). Putting gloves on before the gown leaves the cuffs unprotected (Choice 1). Removing contaminated gown and gloves in the hallway spreads organisms (Choice 3). Isolation gowns are not reused between patients (Choice 4). Tucking contaminated gloves under the gown sleeve and removing both as one piece is not the specified safe sequence (Choice 6).
Memorize the CDC PPE order with two memory hooks: DON outside-in (gown→mask→goggles→gloves) so each layer covers the previous, and DOFF dirty-first (gloves→goggles→gown→mask) so the most contaminated items come off first while protected by remaining layers. Hand hygiene anchors the sequence at three moments: before donning, after glove removal mid-sequence, and after final mask removal. Why mask is last off: the air in the room is potentially contaminated; you keep airway protection until you have left the room/anteroom. Why gowns are single-patient-use: even visibly clean fabric harbors pathogens — never wear an isolation gown into another patient room. Special cases: N95 respirators get a fit check after donning; powered air-purifying respirators (PAPRs) follow facility protocols; gowns and gloves removal can be combined as a "scrunch and roll" technique that keeps contaminated surfaces inside.
Medical-surgical unit, contact precautions room. Patient: 64-year-old admitted for cellulitis with MRSA-positive wound culture. Sign at door: "Contact Precautions". Nurse arrives at the anteroom with PPE supplies to perform a dressing change.
Donning Sequence — CDC-recommended order for putting on PPE before patient contact: hand hygiene, gown, mask or respirator, goggles or face shield, gloves; gloves are donned last so they overlap gown cuffs to create a continuous barrier
Doffing Sequence — CDC-recommended order for removing PPE after patient contact: gloves, hand hygiene, goggles or face shield, gown, exit room, mask or respirator, final hand hygiene; the mask is removed last because room air is potentially contaminated
Hand Hygiene Anchors — Hand hygiene must be performed at three points during PPE use: immediately before donning, immediately after removing gloves, and immediately after removing the final piece of PPE; the most important infection prevention action is hand hygiene