Why would you do this?

[wish_me_luck, BSN, RN]

Hi,

I am studying for NCLEX and one of the questions is about PPE and removal order in an airborne room.

The following were the choices to put in order: N95 respirator, gloves, gown, googles, and perform hand hygiene.

I thought it was remove gloves first, then googles, gown third, then I put hand hygiene (since you no longer are touching the client), and last N95 resp. My thinking was why would you remove the N95 and then, stand in the room and perform hand hygiene? I got the first three right but got the question wrong due to mixing the N95 and hand hygiene up. It did not say the sink was outside; it said before leaving the airborne room put these in order. I know there is only one order; I just don't really understand the rational why you would stay in a room to perform hand hygiene without a mask on. The part you are touching to remove the mask is the elastic bands, not the mask itself. So, you shouldn't be contaminated...yet you could breathe in particles if you don't have a resp. on.

Someone explain away. Thanks.

[morte, LPN, LVN]

hand hygiene has to be last....can't help you with an explanation about the mask, but for the fact that usually the sink is close to the door.

[Pepper The Cat, BSN, RN]

When you take the mask off, you will contaminate your hands again so will have to wash again anyway.

[Altra, BSN, RN]

Goggles -- gown -- gloves -- mask -- hand hygiene.

In the real world you will not remove your mask until you are outside the room and have shut the door.

[mariebailey, MSN, RN]

I attached a pretty CDC poster for you. The front of the mask is considered contaminated, but you are right; the elastic strings are not. I concur w/Morte - hand hygiene is always last. In the real world, you may not even need all that PPE, depending on the pathogen. http://www.cdc.gov/HAI/prevent/ppe.html

ppeposter.pdf