Understanding Proper Use and Disposal of Protective Gowns for Healthcare Workers

Healthcare workers’ jobs demand a high level of attention to detail, and workers’ Personal Protective Equipment (PPE) choices are important. Face protection and hand hygiene come in several varieties, but they are easy to use and dispose of. However, since there are four levels of gowns to choose from, the proper attire for a given situation may not be intuitive.

The Centers for Disease Control and Prevention (CDC) has many guidelines for the appropriate use of PPE, but your employees can’t stop and check these guidelines every time they have to take on a new task. It’s important to ensure your entire staff understands appropriate gown usage to keep everyone protected and avoid wasting gowns.

Maintaining public health and confidence in health care systems requires constant vigilance. Even if your team is made up of veteran employees, it’s wise to re-examine your infectious diseases prevention protocol and training periodically.

Types of Protective Gowns

The Association for the Advancement of Medical Instrumentation (AAMI) created standards to assess the liquid resistance of various types of medical gowns. Since medical gowns are made of different layers of nonwoven materials, their liquid resistance can vary dramatically.

Assessing the liquid resistance of these materials required rigorous standardized testing measures to keep all products in compliance with these standards. Since the U.S. Food and Drug Administration (FDA) uses AAMI’s standards, the procedures for gown usage are generally the same nationwide.

Level 1 protective gowns have very little fluid resistance and are lightweight. They are designed to protect healthcare workers and visitors in low-risk environments with limited contact with body fluids.

Level 2 gowns are slightly denser and offer a little more protection. These gown types are usually designed as isolation gowns for sterile environments and are appropriate for non-sterile settings.

Level 3 protective gowns have higher water resistance and impact penetration ratings. 

Level 4 have the highest ratings of all due to their special coating and are designed for surgical environments.

All these gowns come in multiple cuff and back styles to accommodate different environments and staff needs. The exact right gowns for you depend on the anticipated exposure to pathogens and bodily fluids.

Low-Risk Environments

Basic check-ups, lab work, and patient transportation are generally considered low-risk activities with minimal risk of exposure to bodily fluids. Emergency department and trauma ward staff may want to err on the side of caution in case they have to help someone suddenly, but generally, these environments require Level 1 or 2 gowns.

Visitors coming to see hospitalized patients may need to wear a Level 1 gown to give their clothes some basic protection and maintain a sterile environment in a patient’s room. Staff will usually wear a Level 2 gown for anything involving drawing blood or assisting an ill patient.

High-Risk Situations

The risk of exposure to patient fluids goes up dramatically in emergency rooms, operating rooms, and any ward that treats seriously ill patients. These environments may involve exposure to fluids at a moment’s notice. Seemingly routine tasks like arterial blood draws also justify the use of a Level 3 or higher gown.

Level 4 gowns are the most appropriate choice for dealing with non-airborne infectious pathogens. Even if the pathogen is only suspected, this gown keeps your staff safe from exposure. Failure to use a high enough gown level could result in illness even if proper gown removal and hand hygiene procedures are followed.

Use of Protective Gowns

Putting on a Gown

For non-sterile environments, wash your hands, remove the gown from its container or packaging, grasp the inside shoulder seams to help open the gown. Push your arm into each sleeve without touching the exterior of the gown. Have a gloved colleague tie the gown in place, or tie it yourself if a colleague is unavailable. According to CDC guidelines, face masks, face shields, and gloves should be put on after the gown, not before.

For sterile environments such as ORs, healthcare workers should always wash their hands and step into a sterile area before putting on a gown. Both a scrub nurse or tech and a circulator nurse can help the worker entering the sterile area to put on gloves and don the gown without touching the outside of it with bare hands.

Employees must make sure their gown fits properly. Surgical gowns need to cover up to the employee’s neckline, with sleeves that are long enough to be covered by rubber gloves. Since gowns that are too small can impede movement, healthcare facilities should keep a full range of isolation gown sizes available at all times.

Disposing of Gowns

After a gown has been used, it should be removed and disposed of in a designated container. The employee should remove their gloves, mask, and eye protection first, then untie the back of the gown. Pull the gown down and forward by the ties, then grasp the inside of the gown to pull the rest of it off.

Employees may need some practice removing gowns correctly, as it is tricky to do without contaminating the hands or clothes underneath. A more experienced employee should observe new employees when removing and folding the gown to ensure that they use the correct technique.

Training and Re-Training

Even experienced nurses and doctors may come across situations where they are not sure what gown to wear. Since infection prevention and control situations vary widely across different specialties, keeping everyone protected in a way that complies with OSHA and FDA regulations is not always obvious.

Management should periodically check employees’ gowns and other types of PPE to make sure they are appropriately clothed for the situation.

Even if they have a good grasp of wearing PPE, all employees should also be re-trained on the general logistics of removing and discarding a gown. This is especially true if they have changed to a different ward with a different layout.

Staying Fully Stocked

Keeping the right PPE supply on hand for your entire staff is challenging, especially if you have a large healthcare facility with complex needs. You need to partner with a supplier that understands the complexities of the PPE market and can get you the gowns you need on time, every time.

ICU Production specializes in providing gowns, gloves, masks, hand sanitizer, and other essentials for healthcare facilities. We work with businesses both large and small to keep your staff working safely. Call our PPE hotline at (323) 881-3279 to learn more about how we can serve you.