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Lesson 19 · PPE & Hand Hygiene

Gear up in the right order.

Gloves, mask, eyewear, gown — the exam rarely asks what they are. It asks what order you put them on and take them off, and when hand hygiene happens. Get the sequence and you've got the questions.

2 sequences to know ~6 min ★ Domain III — Infection Prevention & Hazard Communication
▶ Watch · 2:37
Watch first — donning and doffing PPE in the right order, in under three minutes.
1The problem

The barrier only works in order.

Your PPE — gloves, a mask, protective eyewear, and a gown — is a one-way barrier between you and everything on the patient. But it only protects you if you put it on and take it off in a way that keeps the dirty side away from your skin. That's why there's a fixed sequence, and why the exam loves to test it.

The other half is hand hygiene. Gloves are not a substitute for clean hands — you wash before you glove and after you remove them, every time. Work the sequence below, then we'll turn it into exam answers.

2The instrument

Gearing up, and gearing down.

Two sequences, mirror images of each other. Tap each to watch the order build — notice that gloves go on last and come off first, and hand hygiene bookends both.

The PPE sequence
Fig. 17.1 · interactive
Choose a direction
The order — donning
3The rule, in two lines
On: gloves last
Off: gloves first

Everything hangs off that. Donning runs gown → mask → eyewear → gloves (clean hands first). Doffing reverses to gloves → eyewear → gown → mask (wash hands after). Gloves are outermost and dirtiest, so they go on last and come off first — and clean hands bookend the whole thing.

4On, then off

The whole order on one card.

Read the On column top to bottom to don; read the Off column to doff. Gloves anchor both ends.

PPE item
On · donning
Off · doffing
Hand hygienewash or alcohol rub
Before
After
Gownprotective clothing
1st
3rd
Masksurgical mask / respirator
2nd
4th
Eyeweargoggles / face shield, with side shields
3rd
2nd
Glovesoutermost, dirtiest
Last
First
5Beat the exam

How DANB will actually ask this.

It asks for a position in the order ("what goes on first?", "what comes off first?") or tests the hand-hygiene rule. Anchor everything to gloves last on, first off, and remember gloves never replace clean hands.

"put on first / donning starts with"Gown (after hand hygiene)
"put on last / just before treating"Gloves
"remove first when finished"Gloves (dirtiest)
"after removing gloves you should…"Perform hand hygiene
"gloves instead of washing?"No — never a substitute
6Check yourself
Which item of personal protective equipment is put on last, just before treating the patient?
Gloves. Donning runs gown, mask, eyewear, then gloves. Gloves are outermost, so they go on last — after clean hands — and they'll be the first thing removed.
6Check yourself
When removing PPE after a procedure, which item is taken off first?
Gloves. They're the most contaminated, so doffing starts with gloves, then eyewear, gown, and mask — the reverse of donning. Wash your hands after they're off.
6Check yourself
Wearing gloves during a procedure means hand hygiene is not needed afterward.
False. Gloves can have tiny defects and hands can be contaminated during removal, so hand hygiene is performed before gloving and after every glove removal. Gloves are never a substitute for clean hands.
One anchor holds it together. Gloves last on, first off — and clean hands on both sides.

Everything else falls into place around that: gown before mask before eyewear, then reverse it coming off. When the exam asks for a position in the order, you won't guess — you'll count.

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