SKILLS CHECKLIST

Name_________________________________ Performance Expectations Met______ Date_ ___________ Signed___________________

SKILL 15.3: Donning Sterile Gown and Gloves (Closed Method)

Procedure Performed Comments

Yes No
1. Gathered sterile pack and ensured its sterility. Performed surgical hand antisepsis/scrub.
2. Began donning sterile gown:
a. Grasped sterile gown at the crease near the neck, held it away from body, and
permitted it to unfold freely without touching anything including the uniform.
b. Put hands inside shoulder of gown without touching outside of gown.
c. Worked the hands down the sleeves only to the beginning of the cuffs.
d. Had coworker wearing hair cover and mask reach inside arm seams and pull
gown over shoulders.
e. Coworker grasped the neck ties without touching the outside of the gown and
pulled the gown upward to cover the neckline of the scrub person’s uniform in
front and back.
Applied Sterile Gloves (Closed Method)
3. Opened sterile glove wrapper while the hands were still covered by sleeves.
4. Put the glove on the nondominant hand.
a. With dominant hand, picked up the opposite glove with the thumb and index
finger, handling it through the sleeve.
b. Positioned the dominant hand palm upward inside the sleeve. Laid the glove on
the opposite gown cuff, thumb side down, with the glove opening pointed toward
the fingers.
c. Used the nondominant hand to grasp the cuff of the glove through the gown cuff,
and firmly anchor it.
d. Used the dominant hand working through its sleeve, grasped the upper side of
the glove’s cuff, and stretched it over the cuff of the gown.
e. Pulled the sleeve up to draw the cuff over the wrist as fingers were extended of
the nondominant hand into the glove’s fingers.
5. Put the glove on the dominant hand.
a. Placed the fingers of the gloved hand under the cuff of the remaining glove.
b. Placed the glove over the cuff of the second sleeve.
c. Extended the fingers into the glove and pulled the glove up and over the cuff.
6. Completed gowning as follows:
a. Had a coworker hold the waist tie of the gown, using sterile gloves, forceps,
or drape.
b. Made a three-quarter turn, then took the tie and secured it in front of the gown
OR
c. Had coworker take the two ties at each side of the gown and tied them at the
back of the gown.

Clinical Nursing Skills: A Concept-Based Approach to Learning, Volume III, 2e   Copyright © 2015 by Pearson Education, Inc. All rights reserved.