STERILE GOWNING AND CLOSED

GLOVING TECHNIQUE
DEFINITION
Wearing a sterile gown necessary to safely carry out sterile procedures

ASSESSMENT
1. Assess availability of sterile supplies
2. Assess availability of personnel (e.g., circulating nurse) if help is needed
3. Assess location of sterile field to avoid contamination

OBJECTIVES
 Apply attire necessary to safely carry out sterile procedures.

EQUIPMENTS
 Surgical cap
 Surgical mask
 Sterile gown
 Sterile gloves (proper size)
 Mayo stand or flat surface above waist level

PROCEDURE

STEPS
1. Before entering sterile area of delivery/
operating room, wear surgical cap and face
mask.
2. Perform thorough surgical hand wash.
RATIONALE
Prevents hair and air droplet nuclei from
contaminating sterile work areas.
Removes transient and resident bacteria from
fingers, hands and forearms.

3. Ask circulating nurse to assist by opening Gown’s outer surface remains sterile.
sterile pack containing sterile gown (folded
inside out).

4. Pick up sterile gown below neck edge and lift it Provides wide margin of safety, avoiding
directly upward and step away from table. contamination of gown/ sterile field or table.
 5. Holding folded gown, locate armhole. With Clean hands may touch inside of gown without
both hands, grasp front of gown just below contaminating outer surface.
neckband.
6. Allow gown to unfold, avoid touching the inner Outside of gown will be sterile surface.
portion of the gown (right side) with bare
hands.
7. With hands at shoulder level, slip both arms Careful application prevents contamination.
into armholes simultaneously. Ask circulating Gown sleeves cuff covers hands to prepare for
nurse to bring gown over shoulders by closed gloving.
reaching inside to arm seams. Gown is pulled
on, leaving sleeves cuff covering hands.

8. Have circulating nurse to securely tie back of Gown must completely enclose underlying
gown at neck and waist. garments.

9. Proceed to closed gloving.

GLOVING (Closed Technique)

STEPS RATIONALE
1. With hands covered by cuff of gown sleeves, Hands remain clean. Sterile gown cuff will
open inner sterile glove package. touch sterile glove surface.
2. With non- dominant hand inside gown cuff, pick Sterile gown touches sterile glove.
up glove for dominant hand by grasping folded
cuff.

3. Extend dominant forearm with palm of glove Position glove for application over cuffed
against palm of dominant hand. Glove fingers will hand, keeping glove sterile.
point toward elbow. (Palm to Palm).

4. Grasp back of glove cuff edge with non- Seal created by glove cuff over gown prevents
dominant hand and gown cuff. Dominant hand, exit of microorganisms over operative sterile
thumb, and index finger, holding on to edge of field.
glove.

5. Grasp top of glove and underlying gown sleeve

with covered non- dominant hand. Carefully
extend fingers into glove, being sure glove’s cuff
covers gown’s cuff.

6. Glove non- dominant hand in same manner, Sterile touches sterile.

reversing hands. Use gloved dominant hand to
pull on glove. Keep hand inside sleeve.
 7. Be sure fingers are fully extended into glove
fingers.
8. Hand tie to sterile team members who stand still.
Allowing margin in safety, turn around to the left,
covering back tie from team member and secure
tie to gown.
Ensures that nurse has full dexterity while
using gloved hand.
Contact with team member could
contaminate gown and gloves. Gown must
enclose undergarments.

EVALUATION
1. Contamination is prevented.
2. Sterile attire completely worn.
 SURGICAL HANDSCRUBBING
TECHNIQUE
DEFINITION
A sterile technique of washing hands, forearms and elbows with the use of liquid soap
containing anti- microbial agent using a surgical brush.

ASSESSMENT
1. Assess agency policy regarding surgical hand scrub.
2. Assess hands for cuts, abrasions or traumatized skin that can harbor microorganisms.
3. Assess length and conditions of nails and cuticles. Long nails, artificial nails, and nail polish
should be avoided.
4. Assess that jewelries are removed from hands.

OBJECTIVES
1. Remove as many microorganisms from the hands as possible before a sterile procedure.
2. Decrease the risk of infection for high- risk groups.

EQUIPMENT
 Surgical cap
 Face mask
 Deep sink with foot or knee controls for dispensing water and soap (faucets should be high
enough for hands and forearms to fit comfortably)
 Antiseptic detergent (non- irritating, broad spectrum, effective in reducing skin microorganisms)
 Sterile surgical scrub brush
 Sterile towel

PROCEDURE

STEPS
1. Before starting the hand scrub, remove all
jewelries on your hands and wrists; wear a
surgical cap or hood and a disposable mask.
2. Turn on water using knee or foot controls.
3. Perform hand washing using antiseptic
solution extending up to 5 cm. (2 inches)
above elbow. (Hands need to be above
elbows at all times.)
4. Rinse hands and arms thoroughly under
running water. Remember to keep hands
above elbows.
5. Get wet sterile brush and apply anti-
microbial detergent. Scrub nails of one hand
with 15 strokes. Holding brush perpendicular,
RATIONALE
Jewelry harbors microorganisms.
Mask prevents escape into air droplets
containing microorganisms; prevents hair from
contaminating sterile work areas.
Water runs by gravity from fingertips to elbows.
Hands become cleanest part of upper extremity.
Keeping hands elevated allows water to flow
from least to most contaminated areas.
Rinsing removes transient bacteria from fingers,
hands and forearms.
Scrubbing loosens resident bacteria that adhere
to skin surfaces. Ensures coverage of all surfaces.
Scrubbing is performed from cleanest area
 scrub palm, each side of thumb and fingers, (hands) to marginal area (upper arms) 2 inches
and posterior side of hand with 10 strokes above elbow.
each. The arm is mentally divided into three,
and each third is scrubbed 10 times.

Entire scrub should last 5 to 10 minutes. Rinse

brush and repeat sequence for other arm.
6. Discard brush and rinse hands and arms
thoroughly. Turn off water with foot or knee
control and back into room with hands
elevated in front of and away from the body.
7. Bending slightly forward at the waist, pick
sterile hand towel on top of gown from
opened package. Wipe hand thoroughly. Start
from fingers to elbow using a rotating motion.
Dry from cleanest to least clean area.
8. Repeat drying method for other hand with
unused portion of towel.
9. Discard towel to linen hamper.
After touching skin, brush is considered
contaminated. Rinsing removes resident
bacteria. Prevent accidental contamination.
Drying prevents chapping and facilitates donning
of gloves. Leaning forward prevents touching of
scrub suits and contaminating the hand towel.
Prevents contamination.
Prevents accidental contamination.

Note:
 Avoid touching unsterile areas while scrubbing. If scrubbed area is touched by unsterile
object, such as sink faucet, you must start the scrub over.
 Go to the comfort room before commencing the surgical scrub. It will be very tiresome to
scrub out then scrub in again.
 Same scrub procedure should be utilized for every scrub, whether it is the first or last one of
the day.

EVALUATION
1. Contamination is prevented.
2. Sterile technique is maintained throughout procedures.