Doffing
Doffing is the process of taking off PPE equipment. It entails a series of steps that must be performed in a specific order and with extreme care1 to prevent exposure to infectious agents that may be on the surfaces of PPE as a result of direct patient interaction.
When doffing in any clinical scenario or context, the following precautions can help prevent exposure to infectious agents on the surface of your PPE:
- Avoid touching the outer surfaces of your PPE
- Resist the urge to touch your clothes, skin, hair, or face with your hands until you have performed hand hygiene1
- If necessary/available, consider having a spotter to guide you during the doffing procedure1
Doffing of some or all PPE should be practiced following the treatment of any patient1 and should always occur at a safe distance (at least 2 metres).
Depending on the PPE elements to be doffed, the steps involved may vary; however, the order of steps never changes.
Doffing for Contact and Droplet Precautions2,3
Remove and dispose of gloves
Technique tip 1:
Use the glove-to-glove, skin-to-skin technique
Technique tip 2:
If your gown is disposable, gloves can be removed at the same time as your gown, rolling them into a bundle together
Perform hand hygieneTechnique tip:
Be sure to clean all surfaces of hands and wrists2 for at least 20 seconds
Remove gown and dispose or placeTechnique tip:
Remove your gown by leaning forward and shaking/shrugging, then rolling it into itself in appropriate receptacle for disinfection
Perform hand hygiene
Remove eye protection and place aside for disinfection
Perform hand hygiene
Remove and dispose mask
masks do not necessarily need to be replaced if a full face shield is worn over top2; follow local procedures for preserving unsoiled masks
Perform hand hygiene
When doffing PPE used for airborne precautions (AGMPs), make sure to exit the room and perform hand hygiene before removing your eye protection.4
Doffing for Scenarios without Contact and Droplet Precautions
What to Doff
During COVID-19, the only PPE that should be doffed between the treatment of any patients are:
- Gloves
- Gowns, eye protection, and masks only if they are damaged, wet, damp, or soiled2
For all staff working within 2 metres of HCPs and patients, masking for the full duration of shifts is recommended, and use of eye protection for full duration of shifts should be strongly considered.2
Why don't I doff all PPE after every patient interaction?
These recommendations are in place due to ongoing concerns about diminishing PPE supplies, increasing community transmission, and the potential for asymptomatic, pre-symptomatic, or pauci-symptomatic (presenting few symptoms) transmission from HCPs to patients and patients to HCPs.2
Complete doffing must always be performed before breaks2 and prior to leaving the patient care area1 or the facility.2
How to Doff
Remove and dispose of gloves
Technique tip 1:
Use the glove-to-glove, skin-to-skin technique
Technique tip 2:
If your gown is disposable, gloves can be removed at the same time as your gown, rolling them into a bundle together
Perform hand hygieneTechnique tip:
Be sure to clean all surfaces of hands and wrists2 for at least 20 seconds
Remove gown and dispose or placeTechnique tip:
Remove your gown by leaning forward and shaking/shrugging, then rolling it into itself in appropriate receptacle for disinfection
Perform hand hygiene
Remove eye protection and place aside for disinfection
Perform hand hygiene
Remove and dispose mask
Perform hand hygiene
Only perform if PPE is damaged, wet, damp, or soiled