PPE Donning and Doffing Checklist for Isolation Gowns in Canadian Facilities
An isolation gown only protects you if it goes on and comes off in the right order. Once you enter a patient room, the gown front and sleeves count as contaminated, so a rushed doffing sequence can carry that load onto your uniform, hands, or face. The order below follows PHAC Routine Practices and the CDC's PPE removal sequence.
Level 1 or Level 2: Start with the AAMI PB70 Barrier Level
AAMI PB70 sorts protective apparel into four fluid-resistance barrier levels. Level 1 suits basic care, patient transport, and low-contact tasks. Level 2 is tested against moderate fluid exposure, the level Canadian clinics and long-term care homes choose for wound care, IV starts, and routine contact precautions.
For daily work, a solid middle ground is the CliniEco SMMS 40 gsm Level 2 isolation gown. Its spunbond-meltblown-meltblown-spunbond (SMMS) fabric resists fluid better than a plain polypropylene Level 1 gown, while 40 gsm stays breathable through a shift.
Reserve Level 3 and 4 for high-fluid procedures such as surgery or heavy irrigation, and add eye protection when splash is possible. When in doubt, follow your facility's routine practices risk assessment rather than the gown's colour.
Donning Checklist: Hand Hygiene First, Gloves Last
One rule drives the sequence: what goes on last comes off first. Gloves cover the gown cuffs and come off first because they pick up the heaviest contamination.
- Perform hand hygiene and let hands dry completely.
- Put on the isolation gown, fastening the neck tie and waist tie so the back is fully closed.
- Put on the mask, pinching the nose wire so it covers nose and mouth without gaps.
- Add eye protection over the mask if the task calls for it.
- Put on gloves last, pulling each cuff up over the gown sleeve.
Doffing Checklist: Gloves, Gown, Hands, Eyes, Mask, Hands
Doffing is where most self-contamination happens, usually from rushing. Treat the gown front, sleeves, and gloves as contaminated from the moment you enter the room.
- Pinch the outside of one glove at the wrist and peel it off. Slide bare fingers under the cuff of the second glove, peel it off over the first, and discard both without touching skin.
- Untie the gown at the waist, then the neck. Peel it off your shoulders and downward, inside out, touching only the inner surface, then roll it into a bundle with the contaminated side trapped and discard it.
- Perform hand hygiene.
- Remove eye protection by the headband or earpieces, never by the front.
- Remove the mask last by the ear loops or ties and discard it.
- Perform hand hygiene once more.
The inside-out roll in step 2 is the move worth practising: it keeps the contaminated outer fabric off your scrubs and skin. Some facilities combine glove and gown removal into one motion, which is fine as long as the mask comes off last.
When to Change an Isolation Gown
Change a single-use gown between every patient, and immediately when it becomes soiled, wet, or damaged or touches blood or body fluids. A torn gown is no barrier at all.
Never wear the same gown for two patients, even if it looks clean, and remove it at the doorway or anteroom straight into the receptacle.
Stock the Doorway So the Sequence Is Easy to Follow
A checklist fails when the cart is empty. With CliniEco 3-ply ASTM Level 1 procedural face masks and 4 mil nitrile gloves beside the gown rack, nobody improvises mid-task. Restock every shift.
Frequently Asked Questions
What is the correct order for donning an isolation gown?
Hand hygiene first, then the gown, mask, eye protection, and gloves last, with cuffs pulled over the gown sleeves. Gown-before-mask keeps the mask seal undisturbed, and gloves last means the most contaminated item comes off first during doffing. Start with an AAMI PB70-rated gown such as the CliniEco SMMS 40 gsm Level 2 model.
Why are gloves removed before the gown when doffing?
Gloves touch the patient and environment most often, so they carry the heaviest contamination. Removing them first means the hands that untie the gown have already been cleaned once, and the gown is peeled off by its clean inner surface. Skipping that order drags glove contamination onto your wrists.
How do I remove a gown without touching the contaminated outside?
Untie the waist tie, then the neck tie. Pull the gown off your shoulders and peel it down over your arms while turning it inside out, touching only the inside of the fabric. Roll it into a bundle and discard it. Removed this way, a single-use gown such as the CliniEco 40 gsm SMMS Level 2 isolation gown never lets its outer surface meet your bare skin.
How often should isolation gowns be changed in a clinic or care home?
Between every patient, and immediately if the gown becomes soiled, wet, torn, or exposed to blood or body fluids. Routine Practices in Canada treat the isolation gown as single-use for each episode of care, so reach for a fresh gown from the CliniEco 50-pack for every new contact.
When should I choose a Level 2 gown over a Level 1 gown?
Choose Level 1 for minimal-exposure work such as patient transport. Step up to an AAMI PB70 Level 2 gown for wound care, IV insertion, and suture removal, since Level 2 passes a tougher water penetration test. For routine contact precautions, many Canadian facilities pair the CliniEco SMMS 40 gsm Level 2 isolation gown with 4 mil nitrile gloves and an ASTM Level 1 mask.
Related Reading
Explore more guides in this category:
- LTC Point-of-Care PPE Checklist: Stocking Gloves, Gowns and Masks
- Masks, Gloves and Gowns per Dentist: A Monthly Consumption Model
- CSA Z314 vs AAMI PB70: Gown Standards for Canadian Buyers
Related reading: explore our infection control resources for clinics.
decode HAI, SSI, CJD and MDRO acronyms in our infection control pillar article.
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