PPE Competency Checklist - Home Care

Use this PPE Competency Checklist to ensure compliance and training for correct donning and doffing of PPE, in particular by home care workers.

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PPE Competency Checklist - Home Care

PPE Competency

PPE Order â€“ On

PPE Order â€“ Off

2. Are the gowns doffed by untying lower ties first and upper last without contamination using the arms cross method, pulling away from the neck and shoulders, touching the inside of the gown, folding or rolling it into a bundle, and discarding it in the appropriate waste container?

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3. Is the mask/face shield doffed by grasping the bottom, untying lower ties first and upper last, pulling up and away from the head, avoiding touching the front of the mask/respirator, and discarding it in the appropriate waste container or storing the mask for reuse per policy?

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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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PPE Competency Checklist - Home Care

Use this PPE Competency Checklist to ensure compliance and training for correct donning and doffing of PPE, in particular by home care workers.

1. Is the proper PPE to gather identified and is all appropriate PPE available at the point of use verbalized?

2. Are proper steps in examining PPE for defects verbalized?

1. Is hand hygiene performed using hand sanitizer for 20 seconds, cleansing all parts of hands, fingers, and nail beds?

2. Are gowns donned, fully covering the torso from neck to knees, arms, ends of wrists, wrapping around the back, and tied/fastened in the back of the neck and waist?

3. Is an N95 respirator donned while ensuring an air-tight fit?

4. Is a seal check performed?

5. Is a face shield donned, placed over the face and eyes, and adjusted to fit as needed?

6. Are gloves donned, covering the wrist of the gown, before entering the patient's home?

1. Are gloves doffed by grasping the outside of the glove with the opposite gloved hand, peeling them off using the glove-in-glove technique, and discarding them in the appropriate waste container?

2. Are the gowns doffed by untying lower ties first and upper last without contamination using the arms cross method, pulling away from the neck and shoulders, touching the inside of the gown, folding or rolling it into a bundle, and discarding it in the appropriate waste container?

3. Is the mask/face shield doffed by grasping the bottom, untying lower ties first and upper last, pulling up and away from the head, avoiding touching the front of the mask/respirator, and discarding it in the appropriate waste container or storing the mask for reuse per policy?

4. Is all PPE discarded by placing it in an external trash can before departing the location, ensuring that PPE is not taken from the home in the staff vehicle?

5. Is hand hygiene performed using hand sanitizer?