Notes

Transmission-Based Garments, or PPE
Patients with highly communicable diseases must be placed in isolation rooms. When healthcare workers enter isolation rooms, they must wear transmission-based garments. Transmission-based garments are more commonly called personal protective equipment, or PPE. Recall that there are three types of transmission-based precautions: contact, droplet, and airborne. These precautions require different types of PPE. Healthcare workers must wear appropriate PPE based on the patient’s diagnoses or suspected diagnoses.

Donning and Removing PPE
The correct sequence for donning any PPE is gown first, mask second, eyewear third, and gloves last. To remove PPE, take off the gloves first, then eyewear, then the gown, and finally the mask. Always perform hand hygiene before donning PPE and immediately after removing PPE. Also, do not touch the outer surface of any PPE. The outer surfaces are considered contaminated, and touching the surfaces may cause infection. Special care must be taken when removing PPE because the items may be contaminated with highly infectious pathogens. Remove gloves and gown by turning inside out to contain infectious pathogens. After removal, PPE used for a patient on transmission-based precautions must be disposed of in a biohazard waste container. Biohazard waste containers are emptied between patients to prevent the spread of infectious agents. PPE must be removed and disposed of inside the door of the patient's room. If PPE is taken outside of the room, the infection may spread to surrounding rooms.

Procedure for Donning Transmission-Based Garments
Follow these steps to don transmission-based garments. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a transmission-based garments procedure that might be found at any agency.
1. Cleanse your hands.
2. Put on the gown so that the opening is in the back.
3. Tie the gown at the back of your neck.
4. Overlap the gown in the back, and tie the waist strings.
5. Position the mask so that your mouth and nose are covered. Tie the strings behind your head. If the mask has an elastic band,
pull the band behind your head.
6. Pinch the metal strip over your nose to secure the mask.
7. Position the eyewear or goggles over your eyes, and pull the elastic band behind your head.
8. Put gloves on and pull the cuff of each glove over the cuffs of your gown.

Procedure for Removing Transmission-Based Garments
Follow these steps to remove transmission-based garments. Individual agencies may have specific procedures that their employees must follow. The following process is an example of a transmission-based garments procedure that might be found at any agency.

-To remove a glove, grasp the cuff with the opposite hand. Pull the glove downward while turning it inside out. Do not touch any skin to the outside of the glove.
-Slip the fingers of the ungloved hand beneath the cuff of the gloved hand. Pull the glove downward while turning it inside out. --Dispose the gloves into an infectious waste container.
-Remove the eyewear by touching only the elastic band. Place the eyewear into an infectious waste container or a container for
cleaning and disinfection.
-Untie the gown at the neck and waist. Be sure to touch only the ties, not the gown.
-Use your dominant hand to reach inside the gown at the opposite shoulder and pull down the gown. Touch only the inside of
the gown.
-Gently pull both arms out of their sleeves while flipping the gown inside out.
-Roll the gown into a bundle, touching only the inside of the gown. Dispose the gown into an infectious waste container.
-Remove the mask by touching only the strings or elastic bands. Dispose it into an infectious waste container.
-Cleanse your hands.