PPE Donning Order Checklist Form
Use this form to verify and record each step of the PPE donning process in the correct order.
Hand hygiene performed before donning PPE?
*
Completed
Not completed
Gown donned properly?
*
Completed
Not completed
Mask or respirator applied correctly?
*
Completed
Not completed
Nose clip of mask/respirator adjusted securely?
*
Completed
Not completed
Goggles or face shield put on properly?
*
Completed
Not completed
Gloves donned to cover gown cuffs?
*
Completed
Not completed
All PPE items checked for secure fit and integrity?
*
Completed
Not completed
Is PPE donning sequence followed exactly as protocol?
*
Yes
No
Any issues or difficulties encountered during donning?
*
No issues
Minor issues (resolved)
Major issues (unresolved)
Overall confidence in PPE donning process
*
1
2
3
4
5
Submit Checklist
Should be Empty: