Guidance for Use of Personal Protective Equipment for Healthcare Settings

The goal of this checklist is to guide people about the correct usage of Personal Protective Equipment (PPE) in health care settings such as hospitals, doctor's offices and clinical labs. When used properly, PPE acts as a barrier between infectious materials such as viral and bacterial contaminants and your skin, mouth, nose, or eyes (mucous membranes). The barrier has the potential to block transmission of contaminants from blood, body fluids, or respiratory secretions. PPE may also protect patients who are at high risk for contracting infections through a surgical procedure or who have a medical condition, such as, an immunodeficiency, from being exposed to substances or potentially infectious material brought in by visitors and healthcare workers. When used properly and with other infection control practices such as hand-washing, using alcohol-based hand sanitizers, and covering coughs and sneezes, it minimizes the spread of infection from one person to another. Effective use of PPE includes properly removing and disposing of contaminated PPE to prevent exposing both the wearer and other people to infection.

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Site/Client
Date
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Personal Protective Equipment (PPE) Checklist

Supplies

Alcohol-based hand sanitizer and EPA-registered disinfectant wipes
Signage (to label separate donning and doffing areas)
Chairs (one for donning area, two for doffing area)
Surgical scrubs and washable shoes
Nitrile gloves (extended cuffs and 2 different colors)
Boot covers to mid-calf (impermeable, meets ANSI/AAMI PB70 Level 4 requirements)
Gown to mid-calf, pants with gown (impermeable, meets ANSI/AAMI PB70 Level 4 requirements), or coveralls (meets ASTM F1671 (13.8kPa) requirements)
Fit-tested N95 respirator, NIOSH-certified
Surgical hood (impermeable, meets ANSI/AAMI PB70 Level 4 requirements)
Face shield
Apron (impermeable, meets ANSI/AAMI PB70 Level 4 requirements)

Personnel

Caregiver— providing care, dressed in surgical scrubs (or disposable garments) and dedicated washable footwear
Trained Observer— to observe all PPE donning and doffing to monitor PPE integrity (NOTE: observer should NOT provide physical assistance)<br> - Trained Observer donned in: fluid impermeable or resistant gown, shoe covers, gloves (two pairs, extended cuff), surgical mask and a face shield
“Buddy”/Doffing Assistant— can provide physical assistance for the caregiver in the doffing process (cannot also be the trained observer)<br> - Doffing Assistant donned in: same PPE as the trained observer. If the doffing assistant enters the patient care area, they should be donned in the same PPE as the caregiver

Space

One-way flow from donning area→patient room→doffing area
Donning area— clean area, labeled, with supplies and chair
Doffing area— labeled, with hand sanitizer, wipes, chairs and medical waste disposal

Order of Procedures for Donning (Putting on) PPE

Completed with the “Buddy System” in specified donning area, under the supervision of the Trained Observer
1. Remove all jewelry, tie hair back; men should be clean shaven; secure eye glasses with a tie; change to surgical scrubs and dedicated footwear
2. Apply hand sanitizer
3. Put on boot covers (this step can be omitted if wearing a coverall with integrated socks)
4. Put on inner layer of gloves— extend over wrists
5. Put on gown or coveralls— fully cover torso, arms to wrist, and wrap around the back, inner gloves tucked under the sleeves
6. Put on N95 respirator— fit snug to face and below chin, seal-check respirator prior to entering patient care area
7. Put on surgical hood– covers all hair and ears, and extends past the neck to the shoulders
8. Put on outer apron (if used)
9. Put on outer layer of gloves— extending over the gown cuffs/sleeves
10. Put on face shield
11. Undergo inspection before entering patient care area, no exposed skin, check range of motion to assess proper fit of PPE

Order of Procedures for Doffing (Taking off) PPE

Completed with the “Buddy System” in specified doffing area, under the supervision of the Trained Observer, and with assistance of “Buddy”/Doffing Assistant if needed
1. Undergo inspection to detect visible contamination, rips or tears in PPE (remove with wipe if visibly contaminated)
2. Decontaminate gloves with hand sanitizer/wipes
3. Remove apron (if used)— roll away from you, with soiled surfaces rolled inward
4. Inspect PPE for visible contamination or cuts/tears
5. Decontaminate gloves with hand sanitizer/wipes
6. Remove outer gloves
7. Decontaminate inner gloves with hand sanitizer and inspect for tears
8. Remove face shield— do not touch the front
9. Decontaminate gloves with hand sanitizer/wipes
10. Remove surgical hood
11. Decontaminate gloves with hand sanitizer/wipes
12. Remove gown— pull away from you, rolling inside out
13. Decontaminate gloves with hand sanitizer/wipes
14. Remove boots covers— using clean chair, do not contaminate scrubs
15. Decontaminate gloves with hand sanitizer/wipes
16. Remove inner gloves— touching only the inside of gloves
17. Apply hand sanitizer
18. Don a clean pair of gloves
19. Remove N95 respirator— remove lower strap over the head, followed by upper strap, avoiding contact with front of the respirator
20. Decontaminate gloves with hand sanitizer/wipes
21. Wipe shoes with disinfectant wipes
22. Decontaminate gloves with hand sanitizer/wipes
23. Remove gloves
24. Apply hand sanitizer
25. Undergo final inspection
26. Shower at the end of each shift