Which sequence correctly represents the proper order to put on PPE?

• A. Perform hand hygiene; Put on gown; Put on shoe covers; Put on mask/respirator; Put on eye protection; Put on gloves
• B. Put on glove; Perform hand hygiene; Put on gown; Put on mask/respirator; Put on eye protection; Put on shoe covers
• C. Perform hand hygiene; Put on gown; Put on shoe covers; Put on mask/respirator; Put on eye protection; Put on gloves
• D. Perform hand hygiene; Put on shoe covers; Put on gown; Put on mask/respirator; Put on eye protection; Put on gloves

Answer: (D)

The main idea here is donning PPE in a sequence that minimizes self-contamination and keeps each barrier clean and intact. Start with hand hygiene to remove transient microbes, then apply shoe covers to protect footwear and prevent transferring floor contaminants onto clothing as you proceed. Putting on the shoe covers before the gown helps keep the gown’s lower edges clean as you slip into the gown. Next, put on the gown to cover your clothes and skin, then the mask or respirator to protect the airway, followed by eye protection to shield the mucous membranes of the eyes. Finally, put on gloves to create a clean, protective barrier for your hands after all other PPE is in place. This order keeps the most clean surfaces free of contamination and ensures that each barrier remains effective during the sequence.

Other sequences either place steps in a way that risks contaminating surfaces (for example, donning gloves before ensuring hands are clean, or putting on the gown before protecting the feet and airway), which compromises protection.