The Complete Guide to Nurses’ Personal Protective Equipment (PPE) in Healthcare

Healthcare workers, particularly nurses, are on the front lines of patient care. They are exposed to infectious diseases, hazardous materials, and bodily fluids daily. Personal Protective Equipment (PPE) is their first line of defense, helping to reduce exposure risks and ensure both their safety and the safety of patients.

This guide covers everything about nurses’ PPE—the types, proper usage, correct donning (putting on) and doffing (removal) procedures, and best practices to maximize protection in healthcare settings.

Why PPE Is Essential for Nurses

Nurses handle direct patient care, which increases their exposure to various workplace hazards, including:

• Airborne diseases such as COVID-19, tuberculosis, and influenza
• Bloodborne pathogens such as Hepatitis B, Hepatitis C, and HIV
• Chemical exposure from disinfectants, chemotherapy drugs, and anesthetics
• Sharp object injuries such as needlestick accidents that can transmit infections
• Physical strain and stress from long shifts and moving patients

Without proper PPE, the risk of exposure to these hazards significantly increases, leading to occupational illnesses, infections, and long-term health complications.

Essential PPE for Nurses

The type of PPE a nurse wears depends on the specific task and level of exposure risk. Below are the essential PPE items used in hospitals, clinics, and long-term care facilities.

Gowns and Coveralls

Gowns and coveralls protect a nurse’s skin and clothing from contamination.

• Standard isolation gowns are used for low-risk patient care, protecting against minor fluid splashes
• Fluid-resistant gowns are coated with polyethylene or plastic to resist blood and bodily fluid penetration
• Full-body coveralls are used in high-infection environments like COVID-19, Ebola, and SARS treatment units

Best practices for gown use include ensuring the gown is the correct size to provide full coverage, tying it securely at the neck and waist to prevent gaps, and removing and disposing of gowns properly after each use.

Masks and Respirators

Face masks and respirators prevent the inhalation of harmful airborne particles and protect both the nurse and the patient.

• Surgical masks prevent large droplets from reaching the nose and mouth
• N95 respirators filter out at least 95 percent of airborne particles and are used in infectious disease care
• Powered air-purifying respirators provide continuous airflow and are used in high-risk areas

Best practices for masks and respirators include performing a fit check to ensure an airtight seal with an N95 mask, avoiding touching the front of the mask when removing it, and changing surgical masks after every patient interaction or if they become damp.

Eye and Face Protection

Eye and face PPE shields the mucous membranes of the eyes, nose, and mouth from splashes, sprays, and airborne contaminants.

• Safety goggles provide a sealed barrier to protect against droplets and splashes
• Face shields cover the entire face, offering additional protection over masks and goggles

Best practices for eye protection include cleaning and disinfecting reusable goggles and face shields after each use and ensuring a comfortable fit to prevent fogging and vision obstruction.

Gloves

Gloves are one of the most frequently used PPE items in healthcare, preventing skin contact with infectious agents and hazardous materials.

• Nitrile gloves are stronger and more puncture-resistant than latex gloves
• Latex gloves offer high dexterity and are commonly used in medical settings
• Sterile surgical gloves are used for procedures requiring a sterile field, such as surgeries and wound care

Best practices for gloves include changing them between patients and after touching contaminated surfaces, avoiding touching the face or other PPE with contaminated gloves, and disposing of gloves immediately after use in biohazard bins.

Shoe Covers and Foot Protection

Shoe covers are used in surgical units, isolation rooms, and intensive care areas to prevent contamination from being tracked into clean areas.

Best practices for shoe covers include ensuring they fit snugly over footwear and disposing of them before exiting patient rooms or sterile areas.

How to Properly Put On PPE

PPE Donning Process for Nurses

• Perform hand hygiene by washing hands with soap and water or using an alcohol-based hand sanitizer
• Put on the gown and securely tie or fasten it at the neck and waist
• Wear the mask or respirator and secure it properly over the nose and mouth, performing a seal check if using an N95
• Put on goggles or a face shield and position them to fully cover the eyes without obstruction
• Wear gloves, ensuring they extend over the gown sleeves to provide full coverage

Following this correct order ensures maximum protection and prevents contamination.

How to Properly Remove PPE

PPE Removal Process for Nurses

• Remove gloves first, peeling them off inside out to avoid contamination
• Take off the gown, rolling it inward to prevent contaminating the environment
• Remove goggles or face shield, handling only the straps
• Take off the mask or respirator, touching only the straps or ear loops
• Perform hand hygiene again to eliminate any remaining contaminants

Improper PPE removal increases infection risks, making strict adherence to doffing protocols critical.

Common PPE Mistakes and How to Avoid Them

Despite strict guidelines, many healthcare workers unknowingly compromise their safety due to PPE errors.

Most Common PPE Mistakes

• Reusing disposable gloves when they should be changed after every patient
• Wearing masks improperly, such as leaving gaps around the nose
• Touching the front of the mask or goggles when removing them, which can transfer contaminants to the hands
• Failing to wash hands after PPE removal, increasing infection risk

How to Avoid These Mistakes

• Always follow the correct donning and doffing sequence
• Perform regular PPE training to reinforce proper usage
• Dispose of contaminated PPE in designated waste bins

The Future of PPE in Healthcare

Advancements in PPE technology continue to improve nurse safety and comfort.

• Self-sterilizing PPE includes gowns and masks with antimicrobial coatings
• Smart respirators are equipped with real-time air filtration monitoring
• Biodegradable PPE provides environmentally friendly disposable options

These innovations will help enhance protection while addressing sustainability concerns.

PPE Storage and Maintenance for Nurses

Proper storage and maintenance of PPE ensure its effectiveness and longevity, especially for reusable items such as goggles, face shields, and respirators.

Best Practices for PPE Storage

• Store PPE in clean, dry, and temperature-controlled areas to prevent contamination and degradation.
• Keep disposable PPE separate from reusable PPE to maintain hygiene standards.
• Use designated storage racks or sealed containers for items like masks, gowns, and gloves to avoid dust accumulation.

Best Practices for PPE Maintenance

• Inspect PPE before and after each use for damage, wear, or contamination.
• Clean and disinfect reusable PPE according to manufacturer guidelines.
• Replace PPE as recommended by regulatory agencies or upon signs of wear.
• Ensure proper drying of disinfected PPE to prevent mold and bacteria growth.

PPE that is not stored or maintained properly loses effectiveness and increases the risk of contamination.

Regulatory Compliance and PPE Standards

To protect healthcare workers and maintain patient safety, strict PPE regulations and standards are enforced by health agencies. Nurses must ensure compliance with these guidelines to reduce risk and liability.

Key Regulatory Agencies and Standards

• Occupational Safety and Health Administration (OSHA) – Sets workplace safety regulations, including PPE requirements for hazardous exposure.
• Centers for Disease Control and Prevention (CDC) – Provides infection control guidelines for PPE use in healthcare settings.
• Food and Drug Administration (FDA) – Regulates medical-grade PPE, ensuring its safety and effectiveness.
• World Health Organization (WHO) – Issues PPE recommendations during pandemics and outbreaks.

PPE Compliance Checklist for Nurses

• Ensure PPE meets OSHA and CDC standards for infection control.
• Follow hospital and facility-specific protocols for PPE use and disposal.
• Stay updated on PPE regulations during public health emergencies, such as COVID-19.
• Participate in regular PPE training and drills to reinforce compliance.

Compliance with PPE standards reduces workplace hazards and ensures legal and ethical responsibility in patient care.

Sustainable PPE Practices in Healthcare

The increased demand for disposable PPE has led to environmental concerns regarding waste accumulation and pollution. Sustainable alternatives and responsible disposal practices can reduce environmental impact without compromising safety.

Eco-Friendly PPE Solutions

• Biodegradable Gloves and Masks – Made from compostable materials that break down naturally.
• Reusable PPE Options – Face shields, respirators, and gowns designed for multiple uses with proper sanitization.
• Sustainable Manufacturing – PPE made with lower carbon footprints and recyclable materials.

Proper PPE Waste Management

• Segregate PPE waste based on contamination risk, ensuring biohazardous materials are disposed of safely.
• Use hospital-approved recycling programs for PPE materials such as face shields and reusable gowns.
• Implement waste reduction initiatives, such as reducing single-use PPE where possible without compromising safety.

Hospitals and healthcare facilities can balance safety with sustainability by adopting eco-friendly PPE strategies.

The Future of PPE in Nursing

PPE technology continues to evolve, offering enhanced protection, comfort, and usability for nurses.

Innovations in PPE Design

• Self-Decontaminating PPE – Gowns and masks infused with antimicrobial coatings to kill pathogens on contact.
• Smart Respirators – Equipped with real-time air filtration monitoring and adjustable airflow to reduce discomfort.
• Ergonomic PPE Designs – Lightweight materials and improved breathability for extended wear.

Challenges in PPE Advancement

• Cost Considerations – Advanced PPE technology often comes with a higher price tag, limiting accessibility for smaller healthcare facilities.
• Supply Chain Stability – Global demand for PPE can create shortages and distribution challenges.
• User Acceptance – Nurses and healthcare workers must be trained on new PPE technologies to ensure proper use.

Future PPE developments will focus on enhancing protection, improving user comfort, and addressing environmental sustainability.

Conclusion

Nurses rely on PPE to stay safe while providing essential care. By wearing the correct PPE, following proper donning and doffing procedures, and avoiding common mistakes, they reduce the risk of infection and ensure a safer work environment.

As healthcare evolves, continuous training and adherence to PPE protocols remain critical in protecting frontline workers and their patients.