How to Properly Don and Doff an Isolation Gown: Step-by-Step
Quick Summary: The order in which you put on and take off an isolation gown determines whether you protect yourself or contaminate yourself. Canadian care teams follow the Public Health Agency of Canada routine practices sequence: gown before gloves when donning, gloves first when doffing. This article walks through each step, notes common mistakes that lead to self-contamination, and explains what to look for when stocking gowns.
A PSW in an Ontario long-term care home once told us she tears the neck tie of every gown because "it is faster to rip it off than to untie it." Fast, yes. Safe, no. Ripping the gown off at the neck pulls the contaminated front panel across your face and uniform. The correct sequence exists for a reason, and it is worth running every shift the same way.
Why the Sequence Matters
An isolation gown is a barrier, not a clean garment. After patient contact, the front and sleeves are considered contaminated. Doffing in a specific order removes the dirtiest items first, then the items closer to your skin, so your hands stay clean at the final step. The Public Health Agency of Canada routine practices guidance sets the sequence for Canadian healthcare workers: hand hygiene, then gown, then mask, then eye protection when donning; gloves, then gown, then eye protection, then mask when doffing.
How to Don an Isolation Gown
- Perform hand hygiene. Wash with soap and water or use an alcohol-based hand rub.
- Put on the gown. Slip your arms in and pull it over your shoulders and torso, back opening facing away.
- Fasten the neck ties. Tie or snap the neck closure first; a slipping gown leaves skin exposed.
- Fasten the waist ties. Reach behind, overlap the back panels and secure. Place thumb loops over the gloves after glove application.
- Complete the rest of your PPE. Mask, eye protection, then gloves over the gown cuffs.
How to Doff an Isolation Gown
- Remove gloves first. Peel the first glove off and hold it in the gloved hand; slide bare fingers under the second cuff, peel it off without touching the outside, and discard both.
- Untie or unsnap the waist ties. If the waist is breakaway, break it. Do not reach for the front.
- Untie the neck ties. Reach behind your neck and untie, or break the fastener. Do not touch the front panel.
- Peel the gown off from the inside. Grasp the inside at the shoulders and pull it away, turning it inside out and rolling the contaminated outside inward.
- Discard the gown. Drop it into the designated receptacle without shaking it.
- Perform hand hygiene again. The gown is the last item before clean hands.
Common Doffing Mistakes
The fastest way to fail this sequence is to pull the gown off by the front panel — that drags contamination across your scrubs and skin. Two other frequent errors: removing the gown before the gloves, and skipping the final hand hygiene step. Treat every gown as contaminated once the patient interaction starts, no matter how short it was.
What to Look For When Stocking Gowns
Gown selection affects how well staff can follow this sequence. A gown with proper overlap and secure fasteners makes doffing predictable; a flimsy gown tears at the neck and encourages shortcuts. For most LTC and clinic contact precautions, a fluid-resistant non-woven gown is the workhorse choice, with an SMS 40gsm level 2 gown for splash-prone tasks and a PLA biodegradable option for sustainability goals.
Check sizing before ordering in bulk: a gown that is too short exposes the lower legs, and one that is too tight restricts movement. Verify the fasteners match staff preference, and confirm material claims against your infection control policy.
For the gown itself, see the CliniEco Medical SMS 40gsm level 2 isolation gown, the level 1 non-woven fluid-resistant gown, or the PLA biodegradable gown. Pair with nitrile exam gloves that fit over the cuffs, and run a doffing drill with new staff before their first assignment.
Frequently Asked Questions
Do I remove gloves or gown first when taking off PPE?
Gloves come off first. Removing the gown first leaves your hands bare while you handle the most contaminated layer. In the PHAC routine practices sequence, gloves are doffed first.
Can I reuse an isolation gown if it looks clean?
No. An isolation gown is single-use and should be discarded after each patient interaction or task, even with no visible soil. Microbial transfer happens without stains.
What level of isolation gown do LTC homes need?
For routine contact precautions, a fluid-resistant level 1 or level 2 gown fits most LTC tasks. For splash-prone procedures such as wound irrigation, choose a higher fluid resistance rating. Review your facility's policy and provincial guidance for specific scenarios.
Why does the PHAC sequence put the gown on before the mask?
Donning proceeds from the largest barrier to the smallest: gown, then mask, then eye protection, then gloves. This keeps the mask outside the gown collar and gloves as the final layer over the cuffs.
Sources
- Public Health Agency of Canada — Routine practices and additional precautions: PHAC routine practices
- Health Canada — Medical devices overview: Canada.ca medical devices
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