Name: ________________________ Date: _____________ Group: ______________

Performance Evaluation Tool for Gowning and Gloving (Closed Method)

0 – not done 1- incorrectly done 2 – correctly done

PROCEDURE 0 1 2 REMARKS
1. Check the client record and ask about latex allergies. Use no latex whenever possible.
2. Assemble all necessary equipment.
 Sterile pack containing a sterile gown
 Sterile gown
3. Ensure the sterility of the package gloves
PROCEDURE
1. Introduce yourself, and verify client’s identity.
Explain to the client what you are going to do, why it is necessary, and how the client can cooperate.
2. Observe appropriate infection control procedures.
3. Provide for Client Privacy
Donning a Sterile Gown
4. Open the package of sterile gloves.
 Remove the outer wrapper from the sterile gloves, and leave the gloves in their inner sterile
wrapper on the sterile field.
5. Unwrap the sterile gown pack
6. Perform hand hygiene
7. Put on the sterile gown
 Grasp the sterile gown at the crease near the neck, hold it away from you, and permit it unfold
freely without touching anything, including the uniform.
 Put the hands inside the shoulders of the gown, and work the arms partway into sleeves without
touching the outside gown.
 If donning sterile gloves using closed method, work the hands down the sleeves only to the
proximal edge of 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)
DONNING STERILE GLOVES (CLOSED METHOD)
8. Open the sterile wrapper containing the sterile gloves
 Open the sterile glove wrapper while the hands are still covered by the sleeves
9. Put the gloves on the dominant hand
 With the dominant hand, pick up the opposite glove with the thumb and the index fingers,
handling it through the sleeve.
 Lay on the opposite gown cuff, thumb side down, with the gown opening 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 sleeves, grasp the upper side of the gloves cuff, and
into the glove’s fingers
10. Put the glove on the dominant hand
 Place the fingers of the glove hand under the cuff of the remaining glove.
 Place the glove over the cuff of the second sleeve.
 Extend the fingers into the gloves as you pull the glove up over the cuff.
Completion of Gowning
Complete the gowning as follows:
 Have a co – worker hold the waist tie of your gown, 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 the two ties at each side of the gown, and tie them at the back of the gown,
making sure that your uniform is completely covered.
 When worn, sterile gown 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 the sterile field.
11. Remove and dispose of used gown and gloves.
 There is no special techniques 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.
TOTAL:
AVERAGE:
Comments:
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Name and signature of Instructor