PPE Donning and Doffing Sequence: Nursing Study Guide

By Nurse on Duty · 07 November 2026 · Based on the sources listed below

The PPE donning and doffing sequence recommended by the CDC is gown, mask or respirator, goggles or face shield, and gloves when putting on, and gloves first, then goggles or face shield, gown, and mask or respirator when taking off. Following this order protects your hands, face, and uniform from contamination, and it is a favourite question in NCLEX and Philippine nursing board exams.

What is the PPE donning and doffing sequence?

Donning means putting on personal protective equipment (PPE), and doffing means taking it off. The sequence is a set order that lowers the chance of spreading germs from the PPE to your skin, clothes, or mucous membranes.

The logic is simple. Gloves go on last so they can cover the cuffs of the gown, and they come off first because they are usually the most contaminated item. The mask or respirator protects your airway, so it stays on until the very end of removal.

The CDC poster notes that the exact procedure should be adapted to the type of PPE used, and that the PPE needed depends on the level of precautions: standard, contact, droplet, or airborne.

Donning sequence: how to put on PPE

Start with clean hands. The Australian Commission on Safety and Quality in Health Care lists hand hygiene as step one before any PPE, and the CDC includes hand hygiene in its safe work practices. Then put items on in this order:

1. Hand hygiene: wash with soap and water or use an alcohol-based hand rub.
2. Gown: cover the body from neck to knees and the arms to the end of the wrists, wrap it around the back, and fasten it at the back of the neck and the waist.
3. Mask or respirator: secure the ties or elastic bands at the middle of the head and neck, fit the flexible band to the bridge of the nose, and make it snug to the face and below the chin. If you wear a respirator, do a fit check.
4. Goggles or face shield: place over the face and eyes and adjust to fit.
5. Gloves: pull them on so they extend over the wrist of the isolation gown.

Doffing sequence: how to remove PPE safely

The CDC gives two acceptable ways to remove PPE. In both, the outside of the gloves, the front of the goggles or face shield, the front and sleeves of the gown, and the front of the mask are all treated as contaminated.

CDC Example 1 (item by item)

1. Gloves: with one gloved hand, grasp the palm of the other glove and peel it off. Hold it in the gloved hand, slide your bare fingers under the remaining glove at the wrist, and peel it off over the first glove. Discard both.
2. Goggles or face shield: remove from the back by lifting the headband or ear pieces. Place reusable items in the designated reprocessing container; otherwise discard.
3. Gown: unfasten the ties, keeping the sleeves away from your body. Pull it away from the neck and shoulders, touching the inside only, turn it inside out, and fold or roll it into a bundle to discard.
4. Mask or respirator: grasp the bottom ties or elastics, then the top ones, and remove without touching the front. Discard.
5. Hand hygiene: wash your hands or use an alcohol-based hand sanitizer immediately after removing all PPE.

CDC Example 2 (gown and gloves together)

In the second method, you grasp the front of the gown with gloved hands and pull it away so the ties break, then fold or roll it inside out. As you remove the gown, you peel off the gloves at the same time, touching only the inside of the gloves and gown with bare hands. Goggles or face shield, then the mask or respirator, and finally hand hygiene follow in the same way as Example 1.

If your hands become contaminated at any point during removal, perform hand hygiene right away before continuing. The Australian poster also builds in hand hygiene after removing gloves and after removing the gown.

Donning vs doffing order at a glance

Where should you remove PPE?

Location matters as much as order. The CDC advises removing all PPE before leaving the patient room, except a respirator, which should be taken off after you have left the room and closed the door.

The Australian Commission poster says removal should begin at the doorway for standard, contact, and droplet precautions, and in the anteroom for airborne precautions. Use the area your facility has marked for doffing, and keep the waste bin within reach.

Which PPE for contact, droplet, and airborne precautions?

Nursing assessment before you put on PPE

• Check the isolation sign and the precautions ordered for the patient.
• Think about the task: will there be splashes, sprays, or contact with body fluids?
• Gather the right PPE in the correct sizes before you start, so you do not leave the room half-dressed.
• Confirm you have been fit-tested for the respirator model you are using if airborne precautions apply.
• Inspect each item and replace anything torn, wet, or damaged.

Nursing considerations and safe work practices

• Keep your hands away from your face while wearing PPE.
• Limit the surfaces and items you touch.
• Change gloves when they are torn or heavily contaminated.
• Perform hand hygiene at every point your facility requires; see our 5 Moments for Hand Hygiene study guide for the WHO moments.
• Place reusable goggles or face shields in the reprocessing container, not the general bin.
• Teach patients and visitors the basics if they also need to wear PPE.

Exam tips

• Doffing is alphabetical: gloves, goggles, gown, and mask follow the same order as the CDC Example 1 sequence.
• Gloves on last, off first: they cover the gown cuffs when donning and are the dirtiest item when doffing.
• Mask or respirator off last: it protects your airway until everything else is removed, and its front is never touched.
• Respirator trap: an N95 is removed outside the room after the door is closed.
• Hand hygiene ends the sequence: an answer that stops at removing the mask is incomplete.
• Match the precaution: contact means gown and gloves, droplet means a mask, and airborne means a fit-tested N95 and an AIIR.

Frequently asked questions

What is the correct order for donning PPE?

According to the CDC, perform hand hygiene first, then put on the gown, then the mask or respirator, then goggles or a face shield, and finally gloves. Gloves go on last so they extend over the gown cuffs. Your facility may adapt this order slightly, so always follow local policy and training.

Why are gloves removed first when doffing PPE?

Gloves usually touch the patient and their surroundings the most, so the outside is the most contaminated part of your PPE. Taking them off first, using the glove-in-glove technique, means you are less likely to carry germs onto your face, eyes, or clothes while removing the other items.

Do you remove an N95 respirator inside or outside the patient room?

Outside. The CDC advises removing all other PPE before leaving the room, then taking off the respirator after you have left and closed the door. Grasp the bottom elastic, then the top, without touching the front, discard it, and perform hand hygiene straight away.

Related on Nurses Notes

• 5 Moments for Hand Hygiene: nursing study guide
• Bundibugyo Ebola outbreak: what nurses should know
• More nursing study guides

Sources

• Sequence for Putting On Personal Protective Equipment (PPE) (poster CS250672-E). Centers for Disease Control and Prevention (CDC).
• Transmission-Based Precautions. Centers for Disease Control and Prevention (CDC), 2024.
• Sequence for putting on and removing personal protective equipment (PPE). Australian Commission on Safety and Quality in Health Care, 2024.

This article is for education only and does not replace advice from your own doctor, nurse, or other qualified health professional. Always follow your facility’s policies and reference ranges.