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DONNING STERILE GLOVES

PROCEDURE

Satisfactory

Unsatisfactory

Removing Sterile Gloves

10.

Grasps outside of one glove at the wrist with the opposite gloved hand and peels off , holding removed glove in the palm of the gloved hand

11.

Removes other glove by sliding fingers of ungloved hand under remaining glove at wrist

12.

Washes hands using the appropriate hand-hygiene procedure

RATING

Satisfactory (performs without supervision)

Competent (no critical errors, corrects with some coaching)

Unsatisfactory (critical errors, requires remediation)

Evaluator Signature: ________________________________________________________    Date: ___________________

Comments/Remedial Action Plan:  _______________________________________________________________________

Student Signature: _________________________________________________________    Date: ____________________

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