iRubric: PPE Infection Control and Transmission-Based Precautions rubric

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PPE Infection Control and Transmission-Based Precautions

Donning and Doffing per CDC guidelines

Rubric Code: X248AWW

By NGHSHOSA

Ready to use

Public Rubric

Subject: Health

Type: Assessment

Grade Levels: (none)

Infection Control Donning and Doffing of PPE
	Basic 0 pts	Developing 2 pts	Proficient 4 pts
Assembled Equipment Gathered Personal Protective Equipment including gloves, mask/respirator, face shield/goggles and gown	Basic The student can gather at least 1 of the following PPE items. Gloves, gown, face shield/goggles and mask/respirator	Developing The student is able to gather at least 2 of the following PPE items. Gloves, gown, face shield/goggles and mask/respirator	Proficient The student is able to gather all PPE. Gloves, gown, face shield /goggles and mask/respirator
Applies in Order The PPE must be put on in this order. Gown, Secure gown at neck and waist, don mask/respirator, then face shield/ goggles then don gloves	Basic The PPE must be put in the correct order without variation. The PPE must be put on in this order. Gown, Secure gown at neck and waist, don mask/respirator, then face shield/goggles then don gloves	Developing The PPE must be put in the correct order without variation. The PPE must be put on in this order. Gown, secure gown at neck and waist, don mask/respirator, then face shield/goggles then don gloves	Proficient The student is able to apply PPE in this order. Gown, secure gown at neck and waist, don mask/respirator, face shield/goggles, and 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 the 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/Respirator/face shield/goggles Picked up the mask/respirator and placed it over the mouth and nose, being careful not to touch the face with the fingers. If the mask has loops, hook them appropriately around your ears. Respirator straps should be placed on the crown of the head (top strap) and the base of the neck (bottom strap). Perform a seal check each time you put on the respirator.	Basic The student completed the following task with 2 or more errors. Picked up the mask/respirator and placed it over the mouth and nose, being careful not to touch the face with the fingers. If the mask has loops, hook them appropriately around your ears. Respirator straps should be placed on the crown of the head (top strap) and the base of the neck (bottom strap). Perform a seal check each time you put on the respirator. Face shield/goggles placed for eye protection	Developing The student completed the following task with only 1 error. Picked up the mask/respirator and placed it over the mouth and nose, being careful not to touch the face with the fingers. If the mask has loops, hook them appropriately around your ears. Respirator straps should be placed on the crown of the head (top strap) and the base of the neck (bottom strap). Perform a seal check each time you put on the respirator. Face shield/goggles placed for eye protection	Proficient The student picked up the mask/respirator and placed it over the mouth and nose, being careful not to touch the face with the fingers. . If the mask has loops, hook them appropriately around your ears. Respirator straps should be placed on the crown of the head (top strap) and the base of the neck (bottom strap). Perform a seal check each time you put on the respirator. Face shield/goggles placed for eye protection
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.
Doffing in Order Gloves, gown, perform hand hygiene remove face shield/goggles then mask/respirator, then washes hands	Basic Students must remove all items in this order without variation or 2 or more errors. Students must remove all items in this order without variation. Gloves, gown, hand hygiene remove face shield/goggles then mask/respirator, then washes hands	Developing Students must remove all items in this order without variation or 1 error. Gloves, gown, hand hygiene remove face shield/goggles then mask/respirator, then washes hands	Proficient Student removes gloves, gown, hand hygiene remove face shield/goggles then mask/respirator, then washes hands
Doffing 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.
Doffing 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.
Doffing Mask/Respirator Removed mask/respirator, touching only the straps. Held the mask/respirator by the straps and discarded in proper receptacle.	Basic The student completed the following task with 2 or more errors. Removed mask/respirator, touching only the straps. Held the mask/respirator by the straps and discarded in the proper receptacle.	Developing The student completed the following task with only 1 error. Removed mask/respirator, touching only the ties. Held the mask/respirator by the straps and discarded in the proper receptacle.	Proficient The student removed the mask/respirator, touching only the straps. Held the mask/respirator by the straps and discarded in proper receptacle.

Subjects:

Health

Types:

Assessment

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