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Gloving Checklist

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kurtfrancis.gaspar
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26 views2 pages

Gloving Checklist

Uploaded by

kurtfrancis.gaspar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OVERALL RATING

DONNING AND DOFFING OF STERILE GLOVES (OPEN METHOD)

PERFORMANCE EVALUATION CHECKLIST

Name: ___________________________________
Section: _________________________________
PERFORMED PERFORMED UNABLE
PROCEDURE INDEPENDENTLY WITH TO REMARKS
ASSISTANCE PERFORM
4-5 2-3 0-1
ASSESSMENT
1. Consider the type of procedure to be
performed and consult agency policy on use of
sterile gloves.
2. Select correct size and type of gloves and then
examine glove package to determine if it is dry
and intact with no water stains.
3. Inspect condition of hands for cuts, hangnails,
open lesions, or abrasions.
4. Assess patient for the risk factors before
applying latex gloves.
PLANNING
5. Expected outcomes following completion of
procedure:
• Patient does not develop signs or symptoms
of infection after procedure.
• Patient does not develop latex sensitivity or
latex allergy reaction
IMPLEMENTATION
1. Wash hands.
2. Remove outer wrapper carefully by separating
and peeling apart sides and lay it on clean, flat
surface.
3. Open inner wrapper and touching only the
outside, secure both flaps in open position.
4. Identify right and left glove. Each glove has cuff
approximately 5 cm and 2 inches wide. Glove
dominant hand.
5. With thumb and first two fingers of non-
dominant hand, grasp the inner fold of the cuff.
Lift the glove, holding away from the body. Slip
dominant hand touching only the inner surface
of the glove.
6. With gloved dominant hand, slip four fingers
underneath second glove cuff. Lift the glove
away from the body.
7. Carefully pull second glove over nondominant
hand and adjust fingers of both gloves using
gloved hand.
8. After second glove is on, interlock hands
together above waist level. The cuffs usually fall
after application. Be sure to touch only sterile
sides
9. Grasp outside of one cuff with other gloved
hand, avoid touching the wrists.
10. Pull glove off, turning it inside out.
11. Take fingers of bare hand and tuck inside
remaining glove cuff Peel glove off inside out
and over previously removed glove. Discard
both gloves in receptacle
DOCUMENTATION
12. Record the specific procedure performed and
patient's response and status.

REMARKS:

__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

CONFORME: STUDENT’S SIGNATURE CLINICAL INSTRUCTOR

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