Xavier University – Ateneo De Cagayan

College of Nursing
PERFORMANCE RATING SCALE
Opening/Closing of D.R Packs

NAME: ____________________________________________ DATE: _________________

BLOCK: ___________________________________________ SCORE: _______________

PERFORMANCE EVALUATION CRITERIA

Scale/Label Performance Quality Assistance

Independent Has mastery of step and ra<onale. Performed Needs no direc<on
5 proficiently, confidently in coordinated manner.
Appropriate use of <me.
Supervised Has some mastery of step and ra<onale performed Requires some
4 step proficiently, confidently in coordinated manner, direc<on
Appropriate use of <me.
Assisted Forgot to men<on and perform the step and Requires some
3 ra<onale but men<oned later and correctly direc<on more
performed. Takes long pauses. oKen.
Marginal Forgot to men<on the step or ra<onale and perform Requires con<nuous
2 the step incorrectly. Spends considerable amount of direc<on.
<me.
Dependent Forgot to men<on the step and the ra<onale. Requires
1 Incorrect performance of the step. Consumed a lot redemonstra<on of
of <me. procedure.
Preparing a Sterile Field
The 1st thing to do when opening a sterile D.R pack is to prepare a sterile field.
Procedure (Steps) 5 4 3 2 1 Remarks
1. Explain the procedure to the pa<ent & perform
hand hygiene.
2. Select a work area that is waist level or higher.
Choose a flat, hard, & dry surface.
3. Put a sterile drape. Sterile drape should be
waterproof on one side w/ that side placed down on
the work surface.
Opening the D.R Pack
4. Check that sterile wrapped drape or package is
dry & unopened. Also note expira<on date, making
sure that the date is s<ll valid.
5. Open sterile wrapped drape, open outer covering.
Remove sterile drape, liKing it carefully by its
corners. Gently shake open, hold away from your
body, & lay drape on selected work area.
6. Place agency-wrapped package in the center of
work area. Touching outer surface only, carefully
reach around item & fold topmost flap of wrapper
away from you. Open Right & leK flap before
grasping the nearest flap & opening toward you.
7. Arrange the instruments appropriately using a
picking forceps and add necessary materials needed
in the delivery.
Adding a Sterile Item to a Sterile Field
8. Hold agency-wrapped item in one hand w/ top
flap opening away from you. With other hand unfold
top flap & both sides. Keeping a secure hold on item,
grasp the corners of the wrapper & pull back toward
wrist, covering hand & wrist.
9. If commercially packaged item has an unsealed
corner, hold package in one hand & pull back on top
cover w/ other hand. If edge is par<ally sealed, use
both hands to carefully peel apart.
 Adding a Sterile Item to a Sterile Field - con<nued

Procedure (Steps) 5 4 3 2 1 Remarks

10. Drop sterile item onto sterile field from a
6” (15cm) ht. or add item to field from the side. Be
careful to avoid dropping onto the 1” border. Discard
wrapper.
Pouring a Sterile Solu<on to a Sterile Field
11. Obtain appropriate solu<on & check expira<on
date.
12. Open solu<on container according to direc<ons
& place cap on table w/ edge up.
13. If bodle has previously been opened, “lip” it by
pouring a small amount of solu<on into waste
container.
14. Hold bodle outside the edge of the sterile field
w/ the label side facing the palm of your hand &
prepare to pour from a height of 4” to 6” (10 to
15cm). The <p of the bodle should never touch a
sterile container or dressing.
15. Pour required amount of solu<on steadily into
sterile container posi<oned at side of sterile field.
Avoid splashing any liquid.
16. Touch only the outside of the lid when
recapping.
Closing D.R Packs
17. Place two wrappers on flat surface with one
point toward you. Place item to be wrapped in the
center of wrapper with its length parallel to you.
18. Fold corner (of top wrapper) nearest you over
item un<l it is completely covered. Fold corner back
toward you 2 to 3 inches. T
19. Fold leK side of wrapper over & parallel to the
item. Fold end of corner back 2 to 3 inches. Repeat
with the right side. Lap center folds at least 1/2 inch.
20. Tuck in side edges of remaining corner to
eliminate any direct opening to item. Bring top to
bodom edges & tuck in, leaving point for opening.
Do the same (step 17, 18, 19, 20) to 2nd wrapper.
and seal the pack with appropriate tape.
or in actual prac<ce in some of our affilia<ng
hospital for 2nd wrapper:
- Fold corner nearest you & <e the side ends
together then tuck in the remaining flap into the <ed
part.

Clinical Instructor’s Signature: _________ Date: ____________

Student’s Signature: _________________ Date: ____________