NETEC Resource Library

Healthcare Workers’ Strategies for Doffing Personal Protective Equipment


Click for External Resource*

Click to read full article*

*The link above may share a zip file (.zip) hosted on Zip files will download automatically.
*All other links are external and will open in a new window. If you click an external link, you are leaving the NETEC site, and we do not maintain, review, or endorse these materials. See our terms of use.

Item Type


Terms of Use

By accessing these materials you are agreeing to our terms of use, which may be found here: Terms of Use.

Share this page:

Was this resource helpful?


Baloh, Jure, Heather Schacht Reisinger, Kimberly Dukes, Jaqueline Pereira da Silva, Hugh P. Salehi, Melissa Ward, Emily E. Chasco, Priyadarshini R. Pennathur, and Loreen Herwaldt. 2019. "Healthcare Workers’ Strategies for Doffing Personal Protective Equipment." Clinical Infectious Diseases 69 (Supplement_3):S192-S8.




Personal protective equipment (PPE) helps protect healthcare workers (HCWs) from pathogens and prevents cross-contamination. PPE effectiveness is often undermined by inappropriate doffing methods. Our knowledge of how HCWs approach doffing PPE in practice is limited. In this qualitative study, we examine HCWs’ perspectives about doffing PPE.


Thirty participants at a Midwestern academic hospital were recruited and assigned to 1 of 3 doffing simulation scenarios: 3 mask designs (n = 10), 2 gown designs (n = 10), or 2 glove designs (n = 10). Participants were instructed to doff PPE as they would in routine practice. Their performances were video-recorded and reviewed with participants. Semistructured interviews about their doffing approaches were conducted and audio-recorded, then transcribed and thematically analyzed.


Three overarching themes were identified in interviews: doffing strategies, cognitive processes, and barriers and facilitators. Doffing strategies included doffing safely (minimizing self-contamination) and doffing expediently (eg, ripping PPE off). Cognitive processes during doffing largely pertained to tracking contaminated PPE surfaces, examining PPE design cues (eg, straps), or improvising based on prior experience from training or similar PPE designs. Doffing barriers and facilitators typically related to PPE design, such as PPE fit (or lack of it) and fastener type. Some participants also described personal barriers (eg, glasses, long hair); however, some PPE designs helped mitigate these barriers.


Efforts to improve HCWs’ doffing performance need to address HCWs’ preferences for both safety and expediency when using PPE, which has implications for PPE design, training approaches, and hospital policies and procedures.


Online through journal subscription (Oxford Academic).