A medical assistant has finished assisting with a wound dressing change on a patient under contact precautions while wearing gloves and a gown, both now contaminated. Standing at the doorway of the room, what is the BEST sequence for the medical assistant to remove the protective equipment and perform hand hygiene?
- ARemove the gown first by untying it from behind, then peel off the gloves, then perform hand hygiene after leaving the room.
- BRemove both gloves and the gown together by pulling them off as one bundle, then perform hand hygiene at the next room.
- CPerform hand hygiene first while still wearing the gloves and gown, then remove the gown and finally the gloves outside the room.
- DRemove the gloves first, then untie and remove the gown by rolling it inward, then perform hand hygiene before leaving the room. Correct
Why A is wrong: Taking the gown off first feels orderly, but the gloves are the most contaminated items and removing the gown while still gloved drags the dirty front of the gown across bare forearms, so the order is wrong.
Why B is wrong: Bundling the items off in one motion seems fast and is sometimes possible with practice, but doing it casually risks splashing or touching the contaminated outer surfaces, and deferring hand hygiene to the next room leaves a gap where the hands stay dirty.
Why C is wrong: Cleaning the hands first sounds cautious, but rubbing alcohol over contaminated gloves does not decontaminate the skin underneath, and removing equipment outside the room can shed contamination into the corridor, so this order is unsafe.
Why D is correct: Gloves are removed first because they are most contaminated, the gown is then rolled away from the body so the dirty surface stays inward, and hand hygiene is performed before leaving, which matches the recommended doffing order.