REMEDIOS T.

ROMUALDEZ MEDICAL FOUNDATION

COLLEGE OF NURSING

PRS IN OPERATING ROOM TECHNIQUE

SURGICAL SCRUB, GLOVING & GOWNING

NAME: _______________________ DATE: ______________ C.I.: __________ GRADE: _______

4- EXCELLENT
3- VERY GOOD
2- SATISFACTORY
1- NEEDS IMPROVEMENT

PROCEDURE 4 3 2 1 REMAEKS
A. Prepare items for procedure.
1. OR gown properly folded.
2. Sterile towel properly folded. Placed on top
of OR gown.
Sterile glove (Correct size) properly prepared.
B. SURGICAL SCRUB
1. OR attire properly worn & fixed. (Head cover,
mask, scrub suit).
2. Wet hands and forearms with the hands
hanging upward using knee/foot control
faucet.
3. Put drops of antiseptic agent into one hand
and lather thoroughly up to 2 inches (5 cm)
above the elbow.
4. Rinse hands and arms thoroughly under
running water with hands positioned
upward, allowing water to drip from the
cleanest are hands down to the elbows.
5. Take a sterile brush (from a package
dispenser) and apply an microbial agent.
6. Place both hands under running water with
the brush in one hand, clean under the
fingernails.
7. Starting with the fingertips, scrub each
anatomic area (nails, fingers & web spaces,
dorsal surface, palmar surface & forearm up
to 2 inches above the elbow) for an amount
of time designated by institution. Scrub
vigorously using circular strokes or using the
brush stroke method, 30 strokes in
fingernails, 20 strokes for each side of the
fingernails, 20 strokes for back of the hand,
20 strokes for the palmar area, 10 strokes for
each side of the forearm up to 2 inches
above the elbow.
8. Repeat nos. 6 & 7 using your other hand &
arm.
9. Rinse the hands and brush or sponge. Discard
brush or sponge afterwards.
 10. Rinse hands thoroughly under running water,
maintaining the upward positioning to allow
water to drip to the flexed elbows. (Avoid
splashing water on the scrub attire)
11. After scrubbing, keep hands higher than the
elbows to allow water to flow from the
cleanest area, the hand, to the marginal area
of the upper arms.
C. DRYING THE HANDS AND ARMS
1. Reach down to the opened sterile package &
pick up the folded sterile towel with one
hand by one corner, while maintaining the
other hand in upward position.
2. Grasp the opposing corner of the towel with
the other hand and open the towel full
length.
3. Use one end of the towel to dry one hand
and arm. (Use circumferential motion to dry
from hand to upper arm). Don’t dry back &
forth.
4. To dry the second arm, hold the dry end of
the towel in the opposite hand & use a
circumferential motion to dry the hand & all
areas of the arm to the elbow.
5. Discard the towel with the hand that is
currently holding it without letting it touch
the scrub suit. ( Do not wad it & toss it across
the room on the laundry hamper).
D. GOWNING TECHNIQUE
1. Reach down to the sterile pack and lift the
folded gown directly upward.
2. Step back from the table into an
unobstructed area to provide a wide margin
of safety while gowning.
3. Holding the folded gown, carefully locate the
neckline and the armholes.
4. Hold the inside front of the gown just below
the neckband with both hands, let the folded
gown unfold, keeping the inside of the gown
toward the body. (Do not touch the outside
of the gown with bare hands).
5. After locating the armholes of the gown,
keeping the hands at shoulder level, slip both
arms into the armholes simultaneously.
(Circulating nurse brings the gown over the
shoulders by reaching inside to shoulder and
arms. The gown is pulled on, leaving the cuffs
of the sleeves extended over the hands. Back
of the gown is securely tied at the waist first
followed by the neckline.
Note: If top of the gown drops downward,
inadvertently, discard the gown and consider it
as contaminated.
E. GLOVING BY CLOSED-GLOVED TECHNIQUES
1. Using the left hand, and keeping it within the
cuff of the left sleeve, pick up the right glove
from the inner wrap of the gloves package by
grasping the folded cuff of the right glove.
2. Extend the right forearm with the palm
upward (supinated). Place the palm of the
right glove against the palm of the right
hand, grasping in the right hand, the top
edge of the cuff, above the palm. In correct
position, glove fingers are pointing toward
you and the thumb of the glove is to the
right.
3. Grasp the back of the cuff in the left hand &
turn & turn it over the end of the right sleeve
and hand. (The cuff of the glove is now over
the stockinet).
4. Grasp the top of the right glove and
underlying gown sleeve with the covered left
hand. Pull the glove on over the extended
right fingers until it completely covers the
stockinette cuff.
5. Glove the left hand in the same manner
reversing hands. Use the gloved right hand to
pull on the left glove.
F. OPEN GLOVING TECHNIQUE
1. With the left hand, grasp the cuff of the right
glove on the inside of the fold and lift from
the wrapper. Take care not to touch the
inner aspect of the wrapper on the sterile
portions of the glove.
2. Align the fingers of the right hand and insert
the right hand into the glove, pulling it on,
leaving the cuff turned well down over the
hand. Be sure to keep the thumb adducted
into the palm of the hand until it is well
inside the confines of the glove.
3. Slip the fingers of the gloved right hand
under the everted cuff, on the sterile side of
the left glove. Pick up the glove and step
back.
4. Align the fingers of the left hand and insert
the left hand into the left glove, keeping the
thumb adducted until well inside the glove.
Pull the left glove on all the way, covering
and enclosing the knitted left cuff at the
wrist.
5. With the fingers of the left hand, pull the cuff
of the right glove over the cuff of the right
sleeve. (Avoid touching the bare wrist).
G. ASSITED GOWNING A TEAM MEMBER
1. Open the hand towel, and lay one end on the
freshly scrubbed team member’s hand, being
 careful not to touch the hand.
2. Lift the gown and unfold it carefully with the
sterile outside toward you and the unsterile
inside toward the person being gowned,
holding it open at the shoulders and neckline
by cuffing over the hands.
3. keeping your hands on the sterile side of the
gown under a protective cuff of the neck and
shoulder area, offer then inside of the gown
for the team member to don. (He or she slips
the arms into the sleeves. (Take care not to
let the sleeves make contact with unsterile
areas).
4. Release the gown when it is secured by the
person being gowned. The team member
hold arms outstretched while the circulator
pull the gown onto the shoulders and adjust
the sleeves so that the cuffs are properly slid
back to expose the hands.
H. ASSISTED GLOVING A TEAM MEMBER
1. Pick up the right glove and grasp it firmly
with the fingers under the everted cuff. Hold
the palm of the glove toward the surgeon.
2. Stretch the cuff sufficiently for the surgeon to
introduce his/her hand. Avoid touching the
surgeon’s hand by holding your thumbs out
or abducting them.
3. Exert upward pressure as the surgeon
plunges his/her hand into the glove.
4. Unfold the everted glove cuff over the cuff of
the sleeve.
5. Repeat the previous steps for the left hand. If
a sterile vest is needed, hold it for the
surgeon so he/she can slip his/her hands into
the armholes. Be careful not to contaminate
the gloves at the neck level. If the gown is a
wraparound, assist the surgeon.
Note: When the scrub nurse assists another
person in gloving:
1. He/she first inflates the gloves to loosen
them for easy access.
2. He/she steps one foot forward to avoid
losing balance when offering the glove.
TOTAL

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CLINICAL INSTRUCTOR