SKILL: Donning a Sterile Gown and Gloves (Closed Method)

To enable the nurse to work close to a sterile field and handle sterile objects freely.
To prevent clients at risk from becoming infected.
PREPARATION RATIONALE
1. Check the client and ask about latex allergies. Use Ensuring that patient is not allergic to latex gloves prevents
non-latex whenever possible. allergic reaction if used.
2. Assemble equipment: It conserves time and promotes error free administration.
 Sterile pack containing a sterile gown
 Sterile gloves
3. Ensure the sterility of the package of gloves To maintain aseptic procedures.
PROCEDURE
1. Perform hand hygiene. This is done to prevent cross infection.
2. Observe appropriate infection control procedures. This prevents transmission of microorganisms.
3. Provide for client privacy. This step helps protect patient dignity.
Donning a Sterile Gown
4. Open the package of sterile gloves. This is to maintain sterility of the gloves.
 Remove the outer wrap from the sterile gloves and
leave the gloves in their inner sterile wrap on the
sterile field.
5. Unwrap the sterile gown pack
6. Put on the sterile gown.
 Grasp the sterile gown at the crease near the neck,  The gown will be unsterile if its outer surface
hold it away from you, and permit it to unfold touches any unsterile objects.
freely without touching anything, including the
uniform.
 Put the hands inside the shoulders of the gown,
and work the arms partway into the sleeves
without touching the outside of the gown.
 If donning sterile gloves using the closed method,
work the hands down the sleeves only to the
proximal edge of the cuffs;
Or
 If donning sterile gloves by using the open
method, work the hands down the sleeves and
through the cuffs.
 Have a co-worker grasp the neck ties without
touching the outside of the gown and pull the
gown upward to cover the neckline of your
uniform in front and back. The co-worker ties the
neck ties. Gowning continues at step 11.
7. Open the sterile wrapper containing the sterile
gloves.
 Open the sterile glove wrapper while the hands are
still covered by the sleeves.
8. Put the glove on the non-dominant hand
 With the dominant hand, pick up the opposite
glove with the thumb and index finger, handling it
through the sleeve.
 Lay the glove on the opposite gown cuff, thumb
side down, with the glove opening pointed toward
the fingers. Position the dominant hand palm
upward inside the sleeve.
 Use the non-dominant hand to grasp the cuff of
the glove through the gown cuff, and firmly
anchor it.
 With the dominant hand working through its
sleeve, grasp the upper side of the glove’s cuff,
and stretch it over the cuff of the gown.
 Pull the sleeve up to draw the cuff over the wrist
as you extend the fingers of the non-dominant
hand into the glove’s fingers.
 9. Put the glove on the dominant hand.
 Place the fingers of the gloved hand under the cuff
of the remaining glove.
 Place the glove over the cuff of the second sleeve.
 Extend the fingers into the glove as you pull the
glove up over the cuff.
Completion of Gowning
10. Complete gowning as follows:
 Have a co-worker hold the waist tie of your gown,  This approach keeps the ties sterile.
using sterile gloves or a sterile forceps or drape.
 Make a three-quarter turn, then take the tie and
secure it in front of the gown.
Or
 Have a co-worker take the two ties at each side of
the gown, making sure that your uniform is
completely covered.
11. When worn, sterile gowns should be considered
sterile in front from the waist to the shoulder. The
sleeves should be considered sterile from 2 inches
above the elbow to the cuff, since the arms of a
scrubbed person must move across a sterile field.
 There is no special technique for removing sterile
attire. If they are soiled, remove them by turning
them inside out.
12. If appropriate, document that sterile technique
was used in the performance of the procedure.
SKILL: Donning and Removing Sterile Gloves (Open Method)
PREPARATION RATIONALE
1. Check client record and ask the client about latex Ensuring that patient is not allergic to latex gloves prevents
allergies. allergic reaction if used.
2. Assemble equipment: It conserves time and promotes error free administration.
 Packages of sterile gloves
PROCEDURE
1. Introduce yourself and verify the client’s identity. Introducing yourself will help establish rapport with the
Explain to the client what you are going to do, patient. Verifying the client’s identity ensures correct
why is it necessary, and how the client can patient and improve patient safety. Discussing the
cooperate. procedure will gain cooperation from the client.
2. Open the package of sterile gloves.
 Place the package of gloves on a clean, dry  Any moisture on the surface can contaminate the
surface. gloves.
 If the gloves are packed in an inner as well as an
outer package, open the outer package without
contaminating the gloves or the inner package.
 Remove the inner package from the outer package.  The inner surfaces, which are next to the sterile
 Open the inner package as in step 4 of the Skill: gloves, will remain sterile.
Establishing and Maintaining a Sterile Field, or
according to the manufacturer’s directions. If no
tabs are provided, pluck the flap so that the fingers
do not touch the inner surfaces.
3. Put the first glove on the dominant hand.
 If the gloves are packaged so that they lie side by  The hands are not sterile. By touching only the
side, grasp the glove for the dominant hand by its inside of the glove, the nurse avoids contaminating
folded cuff edge (on the palmar side) with the the outside.
thumb and first finger of the non-dominant hand.
Touch only the inside of the cuff;
Or
 If the gloves are packaged one on top of the other,
grasp the cuff of the top glove as above, using the
opposite hand.  If the thumb is kept against the palm, it is less
 Insert the dominant hand into the glove and pull likely to contaminate the outside of the glove.
the glove on. Keep the thumb of the inserted hand
against the palm of the hand during insertion.
 Leave the cuff in place once the non-sterile hand
releases the glove.
4. Put the second glove on the non-dominant hand.
 Pick up the outer glove with the sterile gloved  This helps prevent accidental contamination of the
hand, inserting the gloved fingers under the cuff glove by the bare hand.
and holding the gloved thumb close to gloved
palm.  In this position, the thumb is less likely to touch
 Pull on the second glove carefully. Hold the the arm and become contaminated.
thumb of the gloved first hand as far as possible
from the palm.
 Adjust each glove so that it fits smoothly,
carefully pull the cuffs up by sliding the fingers
under the cuffs.
5. Remove the dispose of used gloved.
 There is no special technique for removing sterile
gloves. If they are soiled with secretions, remove
them by turning them inside out.
6. Document that sterile technique was used in the
performance of the procedure.