Gowning and Gloving
-if last number on gown is 1, its a large. 2 is an x-large
-any thing on the slides with *** is a star and highlight
Purpose
gowning and gloving creates a barrier between sterile and nonsterile areas. This protects both the wearer and the patient from cross contamination
Gowning and gloving prevents:
the migration of microorganisms from the surgical team member to the sterile field
contamination of the surgical team member by blood and body fluids
surgical site infection
General Considerations
gown and gloves should be opened on a separate surface from the main sterile field
The individual responsible for establishing the initial sterile field should gown and glove from a separate surface using the closed-gloving method
closed-gloving helps ensure that contamination does not occur
additional sterile team members should be gowned and gloved using the open-assisted gloving method
great care should be taken to avoid splash contamination of both scrub attire and sterile surfaces
self-gowning is the appropriate technique for the individual establishing the initial sterile field; subsequent team members are often gowned via the assisted-gowning technique
spatial awareness is very important
the sterile gown is donned before the gloves
Upon Completion of the Scrub
scrubbed areas aren’t sterile; but surgically clean
proper arm position should ensure that the hands are between waist and mid-chest, and that the hands are maintained above the elbows
ensure that an appropriate distance of 12 inches is maintained between the sterile table surface and the unsterile scrub attire
Drying the Hands and Arms
Make sure you only touch the identified towel. If anything else is touched, that item or surface is considered contaminated
Be careful not to drip water onto any part of the gowning and gloving table. If any drops fall, that item or surface is considered contaminated
When drying, proceed to the wrist and dry the non-dominant arm using circumferential motion in one direction only, to the elbow. Do not move back towards the wrist/hand
Self-gowning Technique
Make sure that you only touch the identified gown. If anything else is touched, that item or surface is considered contaminated
The gown should be grasped
Holding the gown at the inside front (one hand on either side of and just below the neckline), allow the gown to unfold downward; it should unfold away from you (you are looking at/touching the inside of the gown at this point)
Do not allow the top of the gown to drop below shoulder level
Watch sleeves vigilantly while extending one at a time
Do not allow fingers and hand to protrude through the cuff; if they do, you must discard the gown and start anew (can’t proceed with closed-gloving)
Once gown is on, you are almost sterile and can approach the gloving table (not doing so makes you look like a dork)
Closed-gloving Technique
undergloves/glove liners are ½ size larger than your regular size
you can touch and move things on the sterile gloving table
glove should be laying in your palm, thumb down and fingers towards you
hand the paper tag/long tie to an unsterile team member
try to leave a good margin of safety between your right hand and the unsterile team member
General Considerations for Open-gloving
Assisted Open-gloving Technique
make sure that the towels, gloves, and gowns used during this process come from a separate surface, and are NOT contaminated by blood or body fluids from the patient
make sure that your gloves are not contaminated with blood or body fluids from the patient
allow the gown to unfold toward you
an unsterile team member will
always offer the right glove first; completely unfold the glove cuff,
do not allow the glove cuff to snap during release
fingers under the cuff, give it a good stretch
angle the elbows in
Double-gloving (good “which of the following” ?)
double-gloving is recommended for ALL procedures
double gloving provides added protection and reduces the risk of exposure
When double-gloving, the innermost pair should be ½ size larger than your normal glove size; outermost should be normal
Innermost pair should be colored, when possible
colored inner gloves (liners) may not be worn on their own during invasive surgical procedures
double-gloving is not necessary when wearing orthopedic gloves
upon procedural end, all sterile team members should remove the outer gloves prior to applying the sterile dressings
one should also remove the outer gloves (if they are contaminated with blood or body fluids) prior to performing assisted-open gloving for other personnel
Removal of Gown and Gloves
make sure not to grasp too close to the neckline, avoid cross-contamination
gloves will be removed using “glove-to-glove, skin-to-skin” technique
Removal During a Procedure
The gown is always removed first, followed by gloves (glove-to-glove, skin-to-skin)
If a gown and glove removal is done appropriately, rescrubbing is not necessary in order to reenter the sterile field
an unsterile team member will obtain a new sterile gown and gloves for personnel requiring a change
the gown must be rolled off the arms, so that no part of the contaminated inside is
Replacing Contaminated Gloves During a Procedure (know in order)
best to least optimal practice:
contaminated gloves removed by unsterile team member, re-gloved by another sterile team member
completely regown and reglove
Removal of Contaminated Gloves During a Procedure
removal and change depends on the nature of contamination, and whether or not the scrubbed individual is double-gloved
any puncture of a glove necessitates a complete glove change, regardless of whether or not the individual is double-gloved
remember to sequester any instrument suspected in glove perforation; err on the safe side; do not put a suspect instrument down on a sterile surface
When Double-gloved
you may carefully remove the outer gloves yourself; contaminated outer glove
When Single-gloved
the sterile team member, wearing protective gloves, will grasp the contaminated glove about two inches below the top of the cuff and pull it off inside-out (the gown cuff should not be
Donning a Sterile Sleeve
if the nature of contamination only involves an arm (not the gloved hands), then a sterile sleeve may be applied over the contaminated arm
unfold
Gowning and Gloving
-if last number on gown is 1, its a large. 2 is an x-large
-any thing on the slides with *** is a star and highlight
Purpose
gowning and gloving creates a barrier between sterile and nonsterile areas. This protects both the wearer and the patient from cross contamination
Gowning and gloving prevents:
the migration of microorganisms from the surgical team member to the sterile field
contamination of the surgical team member by blood and body fluids
surgical site infection
General Considerations
gown and gloves should be opened on a separate surface from the main sterile field
The individual responsible for establishing the initial sterile field should gown and glove from a separate surface using the closed-gloving method
closed-gloving helps ensure that contamination does not occur
additional sterile team members should be gowned and gloved using the open-assisted gloving method
great care should be taken to avoid splash contamination of both scrub attire and sterile surfaces
self-gowning is the appropriate technique for the individual establishing the initial sterile field; subsequent team members are often gowned via the assisted-gowning technique
spatial awareness is very important
the sterile gown is donned before the gloves
Upon Completion of the Scrub
scrubbed areas aren’t sterile; but surgically clean
proper arm position should ensure that the hands are between waist and mid-chest, and that the hands are maintained above the elbows
ensure that an appropriate distance of 12 inches is maintained between the sterile table surface and the unsterile scrub attire
Drying the Hands and Arms
Make sure you only touch the identified towel. If anything else is touched, that item or surface is considered contaminated
Be careful not to drip water onto any part of the gowning and gloving table. If any drops fall, that item or surface is considered contaminated
When drying, proceed to the wrist and dry the non-dominant arm using circumferential motion in one direction only, to the elbow. Do not move back towards the wrist/hand
Self-gowning Technique
Make sure that you only touch the identified gown. If anything else is touched, that item or surface is considered contaminated
The gown should be grasped
Holding the gown at the inside front (one hand on either side of and just below the neckline), allow the gown to unfold downward; it should unfold away from you (you are looking at/touching the inside of the gown at this point)
Do not allow the top of the gown to drop below shoulder level
Watch sleeves vigilantly while extending one at a time
Do not allow fingers and hand to protrude through the cuff; if they do, you must discard the gown and start anew (can’t proceed with closed-gloving)
Once gown is on, you are almost sterile and can approach the gloving table (not doing so makes you look like a dork)
Closed-gloving Technique
undergloves/glove liners are ½ size larger than your regular size
you can touch and move things on the sterile gloving table
glove should be laying in your palm, thumb down and fingers towards you
hand the paper tag/long tie to an unsterile team member
try to leave a good margin of safety between your right hand and the unsterile team member
General Considerations for Open-gloving
Assisted Open-gloving Technique
make sure that the towels, gloves, and gowns used during this process come from a separate surface, and are NOT contaminated by blood or body fluids from the patient
make sure that your gloves are not contaminated with blood or body fluids from the patient
allow the gown to unfold toward you
an unsterile team member will
always offer the right glove first; completely unfold the glove cuff,
do not allow the glove cuff to snap during release
fingers under the cuff, give it a good stretch
angle the elbows in
Double-gloving (good “which of the following” ?)
double-gloving is recommended for ALL procedures
double gloving provides added protection and reduces the risk of exposure
When double-gloving, the innermost pair should be ½ size larger than your normal glove size; outermost should be normal
Innermost pair should be colored, when possible
colored inner gloves (liners) may not be worn on their own during invasive surgical procedures
double-gloving is not necessary when wearing orthopedic gloves
upon procedural end, all sterile team members should remove the outer gloves prior to applying the sterile dressings
one should also remove the outer gloves (if they are contaminated with blood or body fluids) prior to performing assisted-open gloving for other personnel
Removal of Gown and Gloves
make sure not to grasp too close to the neckline, avoid cross-contamination
gloves will be removed using “glove-to-glove, skin-to-skin” technique
Removal During a Procedure
The gown is always removed first, followed by gloves (glove-to-glove, skin-to-skin)
If a gown and glove removal is done appropriately, rescrubbing is not necessary in order to reenter the sterile field
an unsterile team member will obtain a new sterile gown and gloves for personnel requiring a change
the gown must be rolled off the arms, so that no part of the contaminated inside is
Replacing Contaminated Gloves During a Procedure (know in order)
best to least optimal practice:
contaminated gloves removed by unsterile team member, re-gloved by another sterile team member
completely regown and reglove
Removal of Contaminated Gloves During a Procedure
removal and change depends on the nature of contamination, and whether or not the scrubbed individual is double-gloved
any puncture of a glove necessitates a complete glove change, regardless of whether or not the individual is double-gloved
remember to sequester any instrument suspected in glove perforation; err on the safe side; do not put a suspect instrument down on a sterile surface
When Double-gloved
you may carefully remove the outer gloves yourself; contaminated outer glove
When Single-gloved
the sterile team member, wearing protective gloves, will grasp the contaminated glove about two inches below the top of the cuff and pull it off inside-out (the gown cuff should not be
Donning a Sterile Sleeve
if the nature of contamination only involves an arm (not the gloved hands), then a sterile sleeve may be applied over the contaminated arm
unfold
