How to Put on PPE? Step-by-Step Donning and Doffing

Gown first, mask or respirator second, goggles or face shield third, and gloves last define the CDC-aligned donning sequence, with hand hygiene required before the first item and between every later step. Removal runs in the reverse order, with 20 seconds of hand hygiene between each item so the contaminated outer surfaces never reach your skin or mucous membranes.

This article covers the CDC-aligned sequence healthcare workers and caregivers rely on when entering isolation rooms, clinical spaces, or any environment where contact, droplet, or airborne transmission is a concern.

The Purpose Behind the Sequence

Every item of PPE works as a physical barrier between you and droplets, aerosols, splashes, or direct contact. The order matters because each layer is designed to overlap the one beneath it, building a continuous shield from your torso outward to the air around your head.

If the gown goes on after your gloves, the glove cuff is trapped under fabric and your skin shows at the wrist. If your mask goes on after your face shield, the shield’s band drags across your forehead and across the mask surface. The sequence builds the barrier from the body outward, so every later item reinforces the one before it.

Donning Versus Doffing

Donning is putting PPE on. Doffing is taking it off. Both halves require discipline, but doffing carries the higher risk because the outside of every item is treated as contaminated while your hands are presumed clean. Large reviews in infection-control journals back this up: most self-contamination happens during removal, not entry.

The Clean Zone and the Contaminated Zone

An invisible line cuts across every patient room or isolation area, dividing a clean PPE storage zone from a contaminated zone where gear is removed. Most facilities mark the line with a doorway, a red strip on the floor, or a separate anteroom. Your gloves never cross back into the clean side without passing through a waste bin first.

Preparing Yourself Before Any Gear Goes On

Preparation is where most beginners lose a step. Jewelry, watches, phones, and stoscopes all act as contamination reservoirs if they ride into the room with you. Pull them off or stash them in a clean pouch before you reach for the gown.

Long hair should be tied back, loose sleeves secured, and any food or drink left outside the care area. The goal at this stage is to make your body as smooth and snag-free as possible so every layer of PPE sits flat against you.

Hand Hygiene Comes First

Hand hygiene is the single most repeated action in any PPE routine. Before you touch the first item, wash with soap and water for at least 20 seconds, covering palms, backs of hands, fingers, and thumbs. If a sink isn’t available, an alcohol-based hand sanitizer with at least 60% ethanol works in the same way.

Inspect Every Item

• ▸Gowns: check for tears at the seams and confirm the neck and waist ties are intact.
• ▸Gloves: look for pinholes by inflating the cuff slightly, and check the expiration date on the box.
• ▸Masks and respirators: inspect the straps, nose foam, and any visible soiling.
• ▸Goggles and face shields: wipe the lens clean and confirm the band still has full elasticity.
• ▸Packaging: discard anything with a torn wrapper or a compromised seal.

“Discard, don’t improvise. A gown with a missing tie or a glove with a micro-tear defeats the entire barrier before you start.

The CDC-Aligned Donning Sequence

The CDC’s recommended order for full PPE is gown, mask or respirator, goggles or face shield, then gloves. This sequence builds the barrier from the torso outward and ends with the glove cuff sealing over the gown’s wrist.

Step 1: Put On the Gown

Pick up the gown by the neck opening and let it fall open. Slip your arms into the sleeves, then secure it at the neck first and the waist second. The gown should fully cover your torso from collarbone to knees and wrap around your back. A flat back closure keeps the shoulders from slipping during patient contact.

Step 2: Place the Mask or Respirator

For a surgical mask, place the loops over your ears or tie the bands behind your head, then pinch the nose bridge so the mask conforms to your face. For an N95 or KN95 respirator, position the bottom strap below your ears and the top strap above them, then mold the metal nose piece with both fingertips. Respirator straps should sit flat, never twisted.

Step 3: Add Goggles or a Face Shield

Goggles protect the eyes from splashes and aerosols that a mask alone can’t stop. Place them over your eyes and adjust the band until the foam or gasket sits snugly against your brow. A face shield extends that protection across the full face and is often paired with goggles for high-risk aerosol procedures.

Step 4: Pull On Gloves Last

Gloves go on last so the cuff can stretch over the gown’s wrist, sealing the gap between fabric and skin. Pull each glove on, then pull the gown’s sleeve cuff down slightly so the glove covers it. Smooth out wrinkles at the fingertips to preserve dexterity for patient care tasks.

Fit Checks and Common Wear Errors

Fit determines whether the PPE actually protects you. A mask that gaps at the cheeks or a gown that gaps at the back is a gap in your barrier, even if every other step was perfect.

Performing a User Seal Check on an N95

Pressing the respirator firmly against the skin and checking for leaks confirms that the seal sits flush across the face. For a positive-pressure check, cover the exhalation valve (or the front of the mask if there is no valve) and exhale gently. The mask should bulge slightly without leaking at the edges. For a negative-pressure check, cover the filter surface and inhale gently; the mask should collapse slightly and stay sealed for several seconds.

Spotting Gown, Glove, and Goggle Errors

Dangling gown ties, glove cuffs riding up to expose the wrist, and goggles that gap at the bridge of the nose account for the three most common wear errors. Each one creates a channel where contamination can travel straight to skin or mucous membranes. Pause and readjust before entering the patient zone.

Removing PPE Without Contaminating Yourself

Doffing is where infection control is won or lost. The general rule is reverse order: gloves come off first, then eye protection, then the gown, then the mask or respirator. Hand hygiene runs between every step.

Step 1: Peel Off the Gloves

Use the glove-in-glove technique. Pinch the outside of one glove near the wrist and peel it off, turning it inside out as you go. Ball that glove into the palm of your still-gloved hand, then slide a bare finger under the cuff of the second glove and peel it off, enclosing the first glove inside it. Both gloves end up inside-out, with the contaminated surfaces trapped against each other.

Step 2: Remove Goggles or Face Shield

Handle goggles and face shields by the headband or ear pieces, never the front surface, which is presumed contaminated. Lift them away from your face and place them in a designated receptacle for cleaning or disposal.

Step 3: Untie and Roll the Gown

Untie the waist first, then the neck. Pull the gown forward from the shoulders, rolling it inside-out as you peel it away from your body. Discard it in the appropriate waste container.

Step 4: Remove the Mask or Respirator

For a surgical mask, untie the bottom band first, then the top, and lift the mask away from your face using only the ties. For an N95 or KN95, reach behind your head and lift the bottom strap over your head first, then the top strap. The front of the mask is treated as contaminated throughout.

“Perform a 20-second hand hygiene cue between every removal step. Skipping even one resets the contamination baseline.

Disposal, Reuse, and Choosing the Right Mask

Single-use items, including gloves, gowns, and surgical masks, go straight into the appropriate waste container after removal. Reusable gowns and face shields go into a labeled container for cleaning per facility protocol, which typically involves laundering or disinfection with an EPA-registered product.

Mask choice depends on the scenario. Surgical masks block large droplets and splashes, N95 and KN95 respirators filter aerosols down to about 0.3 microns, and cloth masks offer low-risk source control in community settings.

Store clean PPE in a dry, covered area away from contaminated zones. Humidity, direct sunlight, and exposure to chemicals can quietly degrade elastic and fabric before their first use.

A Printable Quick-Reference Checklist

The sequence becomes automatic only after a few full practice runs. Keep this checklist taped inside a locker or above a doffing station until the order feels like muscle memory.

• ▸Donning: hand hygiene, gown, mask or respirator, eye protection, gloves.
• ▸Doffing: gloves, hand hygiene, goggles or face shield, hand hygiene, gown, hand hygiene, mask, hand hygiene.
• ▸Pause points: 20 seconds of hand hygiene at every transition.
• ▸Mental cue: “Clean inside, contaminated outside” until every item is in the bin.
• ▸Practice: run the full cycle in an empty room before any real patient encounter.

Bottom Line

The barrier only works if the order does. Putting PPE on in the gown-mask-eyes-gloves sequence and reversing it during removal, with hand hygiene at every step, is what separates a routine patient visit from an exposure event. Practice the full cycle until the sequence is automatic, and the gear will do its job every time.

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