Schools of Health and Allied Health Sciences
College of Nursing
PERFORMANCE EVALUATION CHECKLIST
OPEN GLOVING AND REMOVING GLOVES
Name: _________________________________ Year & Section: ____________ Score: _________
Subject: _______________________________ Date: __________________
PROCEDURE CRITERIA
PROFICIENT APPROACHING DEVELOPING BEGINNING
PROFICIENCY
Independently Performs skills Performs skills with
performs all skills Performs skills with with assistance of assistance of faculty
fluently and assistance of faculty faculty 3 - 4 times greater than 4 times
without difficulty. 1 - 2 times during during simulation. during simulation.
simulation.
4 2 1
3
60 POINTS
OPEN GLOVING:
1. Perform thorough hand hygiene.
2. Remove sterile gloves from the outer packaging by
carefully separating and peeling apart sides.
3. Grasp inner package, and lay it on clean, flat surface
just about waist level. Open the inside sterile gloves
wrapper, keeping gloves sterile on wrapper’s inside
surface.
4. With thumb and first two fingers of non-dominant
hand, grasp the edge of the folded cuff of the glove of
the dominant hand. Touch only glove’s inside surface.
5. Carefully pull the glove while you slide your dominant
hand until you have a snug fit over the thumb joints
and knuckles. Your bare non-dominant hand should
only touch the folded cuff – the rest of the glove
remains sterile.
6. With gloved dominant hand, grasp the second glove
by slipping four (4) fingers underneath the glove’s
folded cuff (keeping thumb abducted back/in upright
position).
7. Carefully pull the second glove while you slide your
non-dominant hand. Do not allow fingers and thumb
of gloved dominant hand to touch any part of exposed
nondominant hand. Keep thumb of gloved dominant
hand abducted back/in upright position.
8. Adjust gloves, pull the cuffs, interlock fingers until the
gloves fit properly. Be sure to touch only the sterile
sides.
REMOVING GLOVES:
1. Grasp one glove near your wrist without touching skin.
2. Carefully pull the glove down the palm and fingers,
turning it inside out.
3. Hold the glove in the palm of the still-gloved hand.
4. With ungloved hand, insert two (2) fingers under the
wrist of the other glove.
5. Carefully pull the glove down the palm and fingers,
turning inside out, with the other glove inside.
6. Dispose the gloves safely.
7. Wash hands.
TOTAL
____________________________________________
Signature over Printed name of the Student
____________________________________________
Signature over Printed name of the Clinical Instructor