A nurse is removing personal protective equipment (PPE) after giving direct care to a client who requires isolation. Which of the following PPE items should the nurse remove first?
A.
Gloves
B.
Face shield
C.
Gown
D.
Mask
The Correct Answer and Explanation is:
The correct answer is A. Gloves.
When removing personal protective equipment (PPE) after providing care to a client in isolation, the gloves should be the first item to be removed. Here’s a detailed explanation:
Sequence of PPE Removal:
- Gloves:
Gloves are typically considered the most contaminated PPE item because they are in direct contact with the patient and surfaces in the isolation environment. Removing gloves first minimizes the risk of contaminating the nurse’s hands with pathogens that may have been transferred during care. Proper glove removal requires a technique that avoids touching the outer contaminated surface. The gloves are peeled off by gripping the outside of one glove near the wrist, pulling it inside out, and then removing the second glove by holding it from the inside, which also turns it inside out. - Gown:
The gown is often the next item removed after gloves. Like gloves, gowns can be contaminated, especially on the front and sleeves, which have likely made contact with the patient or the surrounding environment. The gown is untied from the back, and the removal should ensure that the outer surface is not touched directly. It should be pulled away from the body, turning it inside out. - Face Shield or Goggles:
After the gown, the face shield or goggles are removed. This protective equipment serves to shield the eyes and face from splashes or droplets. Since hands should be clean after the removal of gloves and gown, removing the face shield or goggles next reduces the chance of touching the face or head with potentially contaminated hands. - Mask:
The mask is removed last, as it protects the respiratory system from airborne particles. By removing it last, the nurse ensures that the mouth and nose remain protected throughout the removal of the other PPE. When removing the mask, the nurse should avoid touching the front, as this area may be contaminated.
Importance of Following the Correct Order:
Following the correct order when removing PPE reduces the risk of self-contamination. If items like the mask or face shield are removed before the gloves, there’s a higher chance that the nurse may inadvertently touch contaminated surfaces and then touch their face, leading to potential exposure to pathogens. This process is critical in healthcare settings, especially when working with clients who require isolation due to infectious diseases.
Thus, the gloves should always be removed first, ensuring the safety of healthcare workers and preventing the spread of infections.