00 Overview 01 Background 02 Exposure Control
       Measures
03 PPE: When &
       Where to Use
04 PPE: How to Use 05 Additional Safety
       Measures
06 Beyond PPE 07 Resources

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:

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)2.

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

medical gloves washing hands surgical gown washing hands medical goggles washing hands surgical mask washing hands

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:

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
medical gloves washing hands surgical gown washing hands medical goggles washing hands surgical mask washing hands

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

References
  1. BC Centre for Disease Control. COVID-19: Infection Prevention and Control Guidance for Community-Based Physicians, Nursing Professionals and Midwives in Clinic Settings. 2021. http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_IPCGuidanceCommunityBasedHCPsClinicSettings.pdf.
  2. PICNet. How to doff PPE. 2024. https://picnet.ca/wp-content/uploads/How-to-doff-PPE_8-5x11_v8_2024-01-08.pdf.
  3. Government of Canada. Infection prevention and control for COVID-19: Interim guidance for acute healthcare settings. 2021. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/infection-prevention-control-covid-19-second-interim-guidance.html.
  4. BCCDC. 9 Steps to Doff (Take Off) Personal Protective Equipment (PPE) For Airborne Precautions (AGMP). http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_MOH_BCCDC_Doffing_AirbornePrecautions.pdf.