Gowns and Gloves and MasksOh My!

Donning & Doffing your PPE

Daniel Lane, MSN, RN, NE-BC

Teaching Project: Introduction

Setting: Hospital nursing unit with negative pressure isolation rooms

Learner Characteristics:

Adult learners (inter-professionals) with varying degrees of expertise

Modalities of learning: visual, auditory, kinesthetic

Learning Needs Assessment: Short Pre-Assessment on PPE

• T or F: Personal protective equipment (PPE) can reduce contamination of health care personnel hands and clothes.

• T or F: Negative pressure rooms are used to contain airborne contaminants within the room.

• T or F: When removing a gown, it should be turned inside out in a peeling motion and then held close to the body until discarded.

• T or F: Gloves should be changed if moving from a contaminated body site, such as a wound, to a clean body site.

Teaching Project: Purpose

The Purpose of this learning module is to explain and demonstrate the correct way for healthcare providers (HCP) to donn (put on) and doff (take off) Personal Protection Equipment (PPE) used in negative pressure isolation rooms to reduce the potential for airborne infection transmission.

a. Who will learn?RNs, NAs, New Graduate RNs, RTs, PTs, & OTs

b. What will be learned?Proper sequence for donning & doffing PPE

c. Why it is necessary?Protect healthcare providers and patients from infections

d. How knowledge will be used?Knowledge will be used to provide safe patient care and to recognize why negative isolation is used

Three Learning Objectives1. By the end of the lesson, the HCP will be able to

correctly identify 4 PPE items used in patient care and explain the rationale for using the PPE

2. By the end of the lesson, the HCP will be able to differentiate 3 ways that negative pressure isolation and non-negative pressure isolation differ

3. At the end of the lesson, the HCP will be able to correctly demonstrate the 5 steps for donning & doffing PPE for a patient in negative pressure isolation

Description of Teaching StrategyDemonstration – The rationale for using this teaching strategy is that demonstration is designed for learning competencies that involve psychomotor skills.

Summary:• Students will watch a video of the proper steps and create a sequence

checklist based on the steps observed on the video.• Compare & contrast their checklist with correct steps• The students can then simultaneously watch the video, donn and doff

PPE while another HCP observes, monitors the correct checklist, & provides feedback.

• Pre & Post knowledge assessment for Objectives #1 & #2

• (Billings & Halstead, Chapter 15)

Teaching Project Outline:

I. Negative Pressure Facts fact sheet with diagram / pictures

I. 4 Facts on negative pressure isolationII. 3 Facts on non-neg pressure isolation

II. PPE Pictures or PPE demo equipment. Instructor review PPE with students

I. Mask (reg & N95)II. GlovesIII. Hand hygiene productIV. GownV. Goggles

Teaching Project Outline:III. Instructor reviews PPE items IV. Paper with 5 lines x 2 so student can

create checklist (one answer key) / pencilsV. Video Monitor / Computer to watch

donning/doffing videoVI. Video: https://youtu.be/17pViIeUA4U

(mask) ORVII.Video: https://youtu.be/9chxhfXWLws

(N95)

Teaching Project Outline:VIII. Students watch video & write steps down

on paperI. Instructor reviews steps and corrects papers

IX. Instructor does donning & doffing while students watch (using checklist)

X. Students, in partners, practice donning and doffing PPE using checklist

XI. Instructor observes students donning & doffing PPE (final check)

Teaching Project Outline:

XII. Instructor reviews Negative Pressure Fact sheet with students

XIII. Instructor gives post-assessment quiz to students on Neg Pressure Isolation & PPE

XIV. Quizzes are graded and assists students to understand mistakes

Teaching Project Outline:

Negative Pressure Isolation Room

Uses air pressure to contain germs/infectious contaminants in room

Typically needs 6-12 air exchanges per hourAirflow usually comes from hallway and expelled outside

Air Pressure is lower in room than outside the room. The higher pressure outside the room forces air into the room, therefore keeping germs inside the room.

Standing outside the room, you can place a tissue by the floor or door crack to see if the tissue blows towards the door (tissue test)

Non-Negative Pressure Isolation Room

No changes in air pressure between hallway and patient room

No requirement for air exchanges

Positive Air Pressure rooms can be used to protect immunosuppressant patients from contagious diseases, as the air blows out of the room and into the hallway

Tissue by door crack will not be drawn towards the room.

Post Assessment Evaluation

1. The correct order to donn your PPE is:

a) Gloves, Gown, Eye Protection, Mask

b) Gown, Gloves, Face Protection, Mask

c) Gown, Mask, Face Protection, Gloves*

d) Gloves, Mask, Gown, Eye Protection

Salam, Yousuf, & Bakar, S. (2020)

Post Assessment Evaluation

2. The correct order to doff your PPE is:

a) Gloves, Gown, Eye Protection, Mask

b) Gown, Gloves, Face Protection, Mask*

c) Gown, Mask, Face Protection, Gloves

d) Gloves, Mask, Gown, Eye Protection

Salam, Yousuf, & Bakar, S. (2020)

Post Assessment Evaluation3. Characteristics of a negative pressure

room include all the following except :a) Air pressure is used to keep contagious

diseases away from the patient*b) Air pressure is lower in room than in the

hallwayc) Multiple air exchanges per hour are required to

maintain negative pressured) Tissue test results in tissue blowing in towards

door

Teaching Project Summary

• Lesson contains a pre & post assessment

• Lesson uses a multi-modal approach (visual, auditory, kinesthetic) for the adult learner

• Lesson uses Demonstration for students.• Pre-work suitable for Flipped Classroom

approach

Teaching Project Conclusion

• Participants have identified correct PPE equipment

• Participants have explained the proper use of negative pressure isolation rooms

• Participants have demonstrated the correct methods for donning & doffing of PPE

ReferencesBillings, D.M. & Halstead, J.A. (2015). Teaching in

nursing: A guide for faculty (5th ed.). St. Louis, Missouri: Elsevier/Saunders. ISBN-13: 978032329054

Salam, A., Yousuf, R., & Bakar, S. (2020). Multiple choice questions in medical education: How to construct high quality questions. International Journal of Human and Health Sciences (IJHHS), 4(2), 79-88. doi:http://dx.doi.org/10.31344/ijhhs.v4i2.180