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PPE Infection Control and Transmission-Based Precautions 
Rubric Code: MA7BB4
Ready to use
Public Rubric
Subject: Health  
Type: Assessment  
Grade Levels: 9-12

Powered by iRubric Infection Control
Donning and Removal of PPE
  Basic

0 pts

Developing

2 pts

Proficient

4 pts

Assembled Equipment

Gathered Personal Protective Equipment including gloves, mask, and gown

Basic

Student can gather at least 1 of the following PPE items. Gloves, Gown, and Mask
Developing

Student is able to gather at least 2 of the following PPE items. Gloves, Gown, and Mask
Proficient

Student is able to gather all PPE. Gloves, Gown and Mask
Applies in Order

The PPE must be put on in this order. Gown, Secure gown at neck and waist, don mask, then don gloves

Basic

The PPE must be put on the correct order without variation. The PPE must be put on in this order. Gown, Secure gown at neck and waist, don mask, then don gloves
Developing

The PPE must be put on the correct order without variation. The PPE must be put on in this order. Gown, Secure gown at neck and waist, don mask, then don gloves
Proficient

The student is able to apply PPE in this order. Gown, Secure gown at neck and waist, don mask, then don gloves.
Donning Gown

Slipped arms into sleeves of a gown, being careful to touch only the inside of the gown.

Basic

Student put gown on incorrectly and touched the outside of the gown.
Developing

Student was able to slip arm into sleeves of gown, however touched outside of gown.
Proficient

Student is able to Slip arms into sleeves of a gown, being careful to touch only the inside of the gown
Securing Gown

Secured gown at neck and back of waist, covering clothing completely.

Basic

Student not able to secure gown at neck and back of waist and completely cover clothing.
Developing

Student is able to secure gown at neck and back of waist, however clothing not completely covered.
Proficient

Student is able to secure gown at neck and back of waist, covering clothing completely.
Donning Mask

Picked up mask and placed it over the mouth and nose, being careful not to touch the face with the fingers. Tied the ends of the mask around the head and neck.

Basic

Student completed the following task with 2 or more errors. Picked up mask and placed it over the mouth and nose, being careful not to touch the face with the fingers. Tied the ends of the mask around the head and neck.
Developing

Student completed the following task with only 1 error. Picked up mask and placed it over the mouth and nose, being careful not to touch the face with the fingers. Tied the ends of the mask around the head and neck.
Proficient

Student picked up mask and placed it over the mouth and nose, being careful not to touch the face with the fingers. Tied the ends of the mask around the head and neck.
Donning Gloves

Put on gloves, avoiding touching the outside of the gloves. Pulled the glove cuffs over the sleeves of the gown.

Basic

Student completed the following task with 2 or more errors. Put on gloves, avoiding touching the outside of the gloves. Pulled the glove cuffs over the sleeves of the gown.
Developing

Student completed the following task with only 1 error. Put on gloves, avoiding touching the outside of the gloves. Pulled the glove cuffs over the sleeves of the gown.
Proficient

Student able to put on gloves, avoiding touching the outside of the gloves. Pulled the glove cuffs over the sleeves of the gown.
Removes in Order

Gloves, gown, mask, then washes hands

Basic

Students must remove all items in this order without variation. Students must remove all items in this order without variation. Gloves, gown, mask, then washes hands
Developing

Students must remove all items in this order without variation. Gloves, gown, mask, then washes hands
Proficient

Student removes Gloves, gown, mask, then washes hands
Removes Gloves

Removes gloves by folding them down and turning them inside out, then discarded in receptacle for contaminated materials.

Basic

Student completes the following task with 2 or more errors. Removes gloves by folding them down and turning them inside out, then discarded in receptacle for contaminated materials.
Developing

Student completes the following task with only 1 error. Removes gloves by folding them down and turning them inside out, then discarded in receptacle for contaminated materials.
Proficient

Student removes gloves by folding them down and turning them inside out, then discarded in receptacle for contaminated materials.
Removes Gown

Untied ties at neck and waist, removed gown by pulling down from the neck and slipping hands back into gown sleeve, touching only the inside of the gown. Folded the gown down over the arms inside-out and discarded in appropriate receptacle.

Basic

Student completed the following task with 2 or more errors. Untied ties at neck and waist, removed gown by pulling down from the neck and slipping hands back into gown sleeve, touching only the inside of the gown. Folded the gown down over the arms inside-out and discarded in appropriate receptacle.
Developing

Student completed the following task with only 1 error. Untied ties at neck and waist, removed gown by pulling down from the neck and slipping hands back into gown sleeve, touching only the inside of the gown. Folded the gown down over the arms inside-out and discarded in appropriate receptacle.
Proficient

Student untied ties at neck and waist, removed gown by pulling down from the neck and slipping hands back into gown sleeve, touching only the inside of the gown. Folded the gown down over the arms inside-out and discarded in appropriate receptacle.
Removes Mask

Removed mask, touching only the ties. Held the mask by the ties and discarded in proper receptacle.

Basic

Student completed the following task with 2 or more errors. Removed mask, touching only the ties. Held the mask by the ties and discarded in proper receptacle.
Developing

Student completed the following task with only 1 error. Removed mask, touching only the ties. Held the mask by the ties and discarded in proper receptacle.
Proficient

Student removed mask, touching only the ties. Held the mask by the ties and discarded in proper receptacle.




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