KINGDOM OF SAUDI ARABIA

Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

INISTITUTIONAL POLICY AND PROCEDURES

POLICY # : POLICY PAGES : 4

POLICY TITLE : Gowning and Gloving in the Surgical Operating Room

ISSUING DATE : 1/08/2019 EDITION # : 001

REVISION DATE : 30/07/2021 VERSION # : 001

OR MEDICAL STAFF
APPLIED TO : STD # : OR.14
OR NURSES

Statement of Purpose

Definition
1.1 Sterile Gown- are worn over scrub attire (dress or suit) to permit the wearer to
create and to come within the sterile field in the carry out sterile technique during
an operative procedure.
1.2 Sterile Gloves- are worn to permit the wearer to handle sterile supplies or tissues of
the operative wound.

Statement of Policy
2.1 Sterile gowning and gloving are chiefly carried out in operating rooms where surgical
asepsis is necessary.
2.2 The Sterile gown is put on immediately after the surgical scrub. The sterile gloves are put
immediately after gowning.
2.3 After scrubbing hands and arms must be thoroughly dried before the sterile gown is
donned to prevent contamination of the gown by strike through of organisms from skin and
scrub attire.
3.4 Gown are considered sterile in front from shoulder to the level of the sterile field; Sleeves
are considered sterile from 2 inches above the elbow to the stockinet cuff. The back of a
wraparound, sterile back gown is not considered sterile because it cannot

Process & Procedures

1.0 Department-specific applications of transmission-based precautions and endorsement to
OR:

1.1 Patients requiring transmission-based precautions will bypass holding preoperative

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

area and be admitted directly to the operating suite and barriers such as cover
gowns,
gloves and mask will be worn as recommended by standard precaution.

1.2 Procedures will be performed at the end of the day when no other patient’s are in
the
surgical suite and when a minimum of personnel are present.

1.3 When airborne or droplet precautions, the patient will wear a mask in the in the
way
to and from the operating room (in case of known or suspected TB).

1.4 Prior to transporting those patients, the sending area (OR, RR, Nursing floor) will
notify the receiving area (OR, RR, Nursing floor) to allow time for preparation of OR.

1.5 A bacterial filter will be placed on the patient’s anesthesia circuit at the
endotracheal
tube or expiratory side of the circuit.

1.6 After finish of surgery, patient will be recovered in the isolation room or same
operating suite the surgery done and will be discharged to his/her room directly
after
recovered in the OR suite/Isolation room.

1.7 Barriers such as cover gowns, gloves and mask will be worn as recommended by
standard precautions.

2.0 Patients attending OR with pulmonary (suspected or confirmed) tuberculosis:

2.1 Only emergent/urgent surgery or procedures will be performed on patients with

suspected or confirmed pulmonary TB.

2.2 Procedures will be performed at the end of the day when no other patients are in the
surgical suite and when a minimum of personnel are present.

2.3 A bacterial filter will be placed on the patient’s anesthesia circuit at the
endotracheal
tube or expiratory side of the circuit. This may help reduce the risk of discharging
tubercle bacilli into ambient air and for containing anesthesia equipment.

2.4 Disposable single use soda lime will be used in those cases.

2.5 Patients will bypass holding area and be admitted directly to the operating suite.

2.6 Patient will be recovered to Isolation room/same operating suite and will not be
brought to RR.

2.7 The patient will wear a surgical mask route to and from the Operating room.

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

Al-Safwa Hospital – King Abdul-Aziz Road – P.O. Box: 7476 Riyadh 12243 – Direct: 2885444 Page 2 of 4
 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

2.8 Standard PPE and N-95 mask must wear by the HCW to protect the HCW from the
infectious droplet nuclei generated by the patient.

2.9 All disposable equipment must be carefully disposed and careful sterilization of
equipment should be done.

Responsibilities
This policy applies to the nurses, Doctors, Infection Control nurse and housekeeping.

Equipment & Materials

1. Eye protective goggles

2. Gloves

3. Mask

4. Plastic apron

References
 CBAHI Standards
 Ministry of Health
 Http://Www.Cdc.Gov/Hicpac/Pdf/Guidelines/Disinfection_Nov_2008.Pdf

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

Al-Safwa Hospital – King Abdul-Aziz Road – P.O. Box: 7476 Riyadh 12243 – Direct: 2885444 Page 3 of 4
 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

Approval Sheet for

INISTITUTIONAL POLICY AND PROCEDURES

POLICY # : IPP – OR – 017 POLICY PAGES : 4

POLICY TITLE : HANDLING OF INFECTIOUS CASES IN OPERATING ROOM

ISSUING DATE : 01/08/2019 EDITION # : 001

REVISION DATE : 30/07/2021 VERSION # : 001

OR MEDICAL STAFF
APPLIED TO : STD # : OR.14
OR NURSES

Prepared By Reviewed By Reviewed By

Signature Signature
Signature

Date: / /
Date: / / Date: / /

Approved By Approved By

Signature Signature

Date: / / Date: / /

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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