GOWNING AND GLOVING THE SURGEON

Name:________________________________________________________Grade:_________________

Year and Section:____________________ Date:__________________

Legend:
1- Excellent
2- Very Satisfactory
3- Satisfactory
4- Needs Improvement
5- Poor
PROCEDURE RATIONALE 1 2 3 4 5
A. GOWNING THE SURGEON:
1. Open hand towel and hold end part for the Surgeon to
grasp the opposite end of the towel.
2. Grasp the gown in one hand.
3. Shake out stretched hands holding it at the neckband.
4. Offer inside of the gown to the surgeon.
5. Releasee the gown.
B. GLOVING THE SURGEON:
1. Squeeze lubricant or powder on the surgeon’s palm
2. Grasp the right glove firmly with the four gingers under the
turned back-cuff.
3. The palm of the glove should be facing the surgeon.
Stretch the cuff enough to introduce his hands.
4. The surgeon place his hand into the glove. Unfold the
turned back cuff of the glove over his sleeve.
5. Repeat procedure for the left hand.
6. Discard wrapper into the waste container.

Scoring:

1x ____________ = __________

2x ____________ = __________

3x ____________ = __________

4x ____________ = __________

5x ____________ = __________

Total divided by no. of items = __________

Comments:

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Student’s Signature over Printed Name Clinical Instructor’s Signature and Date over

Printed name