Guide — Infection Control
PPE Fundamentals for Nurses
Personal protective equipment (PPE) is the physical barrier between healthcare workers and infectious agents. Correct selection, donning, and doffing are essential — improper PPE use, particularly during doffing, is a leading cause of self-contamination.
10 min read · Infection Control
Educational use only. PPE requirements are based on CDC and OSHA guidelines and facility-specific infection control protocols. For high-risk pathogens (Ebola, novel organisms), follow facility-specific PPE protocols and trained-observer doffing procedures. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Types of PPE
Gloves
Protect hands from contact with blood, body fluids, mucous membranes, nonintact skin, and contaminated surfaces.
Types
- Non-sterile: routine care, examination gloves
- Sterile: invasive procedures, wound care, surgical procedures
Key Rules
- Change between patients and between tasks on the same patient if moving from contaminated to clean area
- Never reuse disposable gloves
- Gloves do NOT replace hand hygiene — wash hands after removing
- Torn or perforated gloves must be removed and replaced immediately
Limitation
Gloves can harbor bacteria on the outer surface — change frequently and perform hand hygiene.
Gowns
Protect clothing and skin from contamination by body fluids, blood, or infectious materials during patient care.
Types
- Isolation gowns: fluid-resistant or fluid-proof
- Surgical gowns: sterile, used in OR
- Non-isolating gowns: not appropriate for infection control purposes
Key Rules
- Tie at neck and waist before patient contact
- Do not touch the outside of the gown when removing
- Remove gown in the patient room or immediately outside — before leaving isolation area
- Dispose of gown in appropriate waste container in room
Limitation
Standard isolation gowns are not fully impermeable — for high-splash procedures, use fluid-proof gowns.
Surgical Mask
Protects mucous membranes of nose and mouth from large droplet sprays. Protects patient from HCP respiratory secretions.
Types
- ASTM Level 1: low-barrier fluid resistance
- ASTM Level 2 & 3: higher fluid resistance for procedures
Key Rules
- Fit mask snugly over nose and chin — mold wire nosepiece to face
- Do not touch front of mask during use
- Do not lower mask to speak or hang around neck
- Replace when wet, soiled, or after aerosol-generating procedures
Limitation
Surgical masks do NOT protect against airborne particles ≤5 µm — N95 required for airborne precautions.
N95 Respirator
Filters ≥95% of airborne particles ≥0.3 µm. Required for TB, measles, varicella, and aerosol-generating procedures on high-risk patients.
Types
- Standard N95: flat-fold or cup-shaped
- Powered air-purifying respirator (PAPR): for higher-risk situations or when fit-testing fails
Key Rules
- Must be fit-tested annually — a respirator that doesn't fit provides no protection
- Perform a user seal check each time (positive/negative pressure check)
- Do not touch front of respirator during use
- Discard immediately if damaged, wet, or soiled
Limitation
Fit-testing is required. Not all N95s fit all face shapes — healthcare workers must be tested for the specific model they use.
Eye Protection
Protects eyes and mucous membranes from splashes, sprays, or aerosols of blood, body fluids, or chemicals.
Types
- Goggles: tight-fitting, provide full eye coverage
- Face shield: protects face including eyes, nose, and mouth
- Safety glasses: NOT adequate for infection control splash protection
Key Rules
- Use goggles or face shield for any splash risk (suctioning, intubation, wound irrigation, airway procedures)
- Clean and disinfect reusable goggles between uses
- Face shields may be used in combination with a mask
Limitation
Prescription eyeglasses are NOT adequate eye protection — wear goggles or a face shield over glasses.
Donning Sequence (Putting PPE On)
PPE must be donned before entering a patient room or care area. The sequence protects both the wearer and the patient from cross-contamination during the donning process.
Hand hygiene
Perform hand hygiene before touching any PPE
Gown
Tie at neck and waist — ensure full coverage of clothing and arms
Mask or N95 respirator
Fit over nose and chin; mold nosepiece; for N95, perform seal check
Eye protection (goggles or face shield)
Place over mask; ensure full coverage of eyes
Gloves
Don last; extend over gown cuffs — no gaps between gown sleeve and glove
Doffing Sequence (Taking PPE Off)
Doffing is the highest-risk step for self-contamination. The outside surfaces of all PPE items are considered contaminated. Remove the most contaminated items first, with hand hygiene between each step.
Critical rule
Do NOT touch the outside (contaminated) surface of any PPE item during doffing. Touch only ties, inner surfaces, or designated doffing areas.
Gloves
Remove first — most contaminated item. Peel off without touching skin. Dispose in room waste.
Hand hygiene
Perform immediately after removing gloves — before touching anything else
Gown
Unfasten ties; peel gown away from body rolling it inward (contaminated side in); dispose in room waste
Hand hygiene
Perform again after removing gown
Eye protection
Remove by touching only the headband or earpieces — not the front lens. Clean/disinfect if reusable.
Mask or N95
Remove last (least contaminated relative to respiratory zone). Touch only ties or ear loops. Do not touch front of mask.
Hand hygiene
Final hand hygiene after all PPE is removed — before leaving isolation area
NCLEX Pearls
- ✦Donning order: hand hygiene → gown → mask/respirator → eye protection → gloves.
- ✦Doffing order: gloves → hand hygiene → gown → hand hygiene → eye protection → mask → hand hygiene.
- ✦N95 requires fit-testing — a surgical mask cannot be substituted for airborne precautions.
- ✦Gloves do not replace hand hygiene — perform hand hygiene after glove removal.
- ✦The outside of all worn PPE is considered contaminated — only touch inner surfaces or ties during doffing.
- ✦For C. diff and norovirus: soap and water, not ABHR — apply this rule after PPE removal as well.
- ✦Prescription eyeglasses are NOT adequate eye protection — wear goggles or face shield over glasses.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with CDC / HICPAC · Infectious Diseases Society of America (IDSA) / SHEA. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →