Surgical Education Learners Forum/Perioperative Nursing/Instrument Handling and Maintaining Sterile Field/Psychomotor Skills Practice Assessment
Assessment Rubric: Instrument Handling and Maintaining Sterile Field – Perioperative Nursing (ECSACONM)
[edit | edit source]Overview
[edit | edit source]This page provides a psychomotor assessment rubric for instrument handling while maintaining a sterile field, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It accompanies the corresponding psychomotor skills practice worksheet and is used to assess learner performance across each step.
Each step is assessed by one of two methods. Articulated steps are scored as either "Not done" (clinically unacceptable) or "Done" (excellent), with no intermediate levels. Observed steps are scored on a five-point scale, with performance anchors defined at level 1 (clinically unacceptable), level 3 (clinically acceptable), and level 5 (excellent); levels 2 and 4 represent performance between the defined anchors.
Assessment Rubric
[edit | edit source]| # | Step Name | Assessment Method | 1 – Clinically Unacceptable | 2 | 3 – Clinically Acceptable | 4 | 5 – Excellent |
|---|---|---|---|---|---|---|---|
| 1 | Set up OR Back table | None | |||||
| 2 | Organizes instrument tables and instruments for safe handling and workflow | Observed and Articulated | Demonstrated table layout/instrument layout is disorganized, sharps are mixed with other instruments, and frequently used instruments are difficult to access. | Demonstrated instruments are grouped logically by function and anticipated use. Sharps, heavy, delicate, clean, and contaminated instruments remain appropriately separated. | Instrument layout is grouped logically and learner can articulate how it is appropriate for the procedure, supports efficient workflow, and allows immediate access to every instrument without searching. | ||
| 3 | Passes and receives back the Scalpel | Observed | Blade toward hand; fingers near blade; unsafe hand-to-hand transfer in either direction | Handle presented safely; blade away from hands. Receives instrument securely; places in appropriate sharps containment area. | Handle placed in usable grip; blade toward field; controlled release/return | ||
| 4 | Performs Alternate pass of Scalpel in kidney dish | Observed | Scalpel passed hand-to-hand; blade toward hand; dish unstable | Scalpel placed securely in kidney dish; handle toward surgeon; blade away from hands. Receives instrument securely; places in sharps area. | Stable dish presented within easy reach; handle oriented for immediate grasp; blade visible and away from hands; dish remains controlled until surgeon removes scalpel. | ||
| 5 | Passes and receives back Ring-handled clamp | Observed | Passed by jaws; rings inaccessible; wrong direction; contamination during passage | Rings toward surgeon; jaws toward field. Receives instrument securely; wipes/cleans; returns to appropriate area. | Rings placed directly into fingers; ready to use; release after surgeon controls. | ||
| 6 | Passes and receives back Tissue/thumb forceps | Observed | Tips toward palm; passed by tips; backwards; contamination during passage | Proximal end toward surgeon; tips toward field. Receives instrument securely; wipes/cleans; returns to appropriate area. | Placed directly into thumb–finger grip; tips ready for use. | ||
| 7 | Passes and receives back Scissors | Observed | Tips toward hand; open during pass; contamination during passage | Closed; rings toward surgeon; tips toward field. Receives instrument securely; wipes/cleans; returns to appropriate area. | Rings placed directly into fingers; blades already oriented for use. | ||
| 8 | Passes and receives back Loaded needle holder | Observed | Needle toward surgeon's hand; loose needle; fingers cross needle; contamination during passage | Needle placed securely and visible; handle toward surgeon; needle away from hands. Receives instrument securely; safely removes needle; returns suture and needle holder to appropriate areas. | Handle placed into operating grip; needle correctly oriented and in correct position in jaws; hands remain behind needle. | ||
| 9 | Passes and receives back a Sponge stick | Observed | Sponge loose; working end toward hand; contamination during passage | Rings toward surgeon; sponge secure; working end toward field. Receives instrument securely; returns to basin. | Rings placed directly into fingers; sponge/shaft already oriented for use. | ||
| 10 | Passes and receives back a Hand-held retractor | Observed | Blade toward hand; backwards; released before controlled; contamination during passage | Handle toward surgeon; blade toward field, edge facing away from hand. Receives instrument back securely; wipes/cleans; returns to appropriate area. | Handle placed firmly into palm; blade correctly oriented; supported until controlled. On return takes positive control; checks instrument/working end; returns clean and organized to its designated location. | ||
| 11 | Passes and receives back Suction | Observed | Passed backwards; tubing tangled/pulling; tubing unsecured on return; contamination during passage | Handle toward surgeon; tip toward field; tubing controlled. Receives suction back securely; shows management/stowing of tubing and securing of suction. | Placed into operating grip; tip ready for use; tubing slack and clear. | ||
| 12 | ESU pencil / cabled instrument | Observed | Active end toward hand; cable tangled; unsafe placement on return; contamination during passage | Handle toward surgeon; tip away from hands; cable controlled. | Placed into operating grip; controls accessible; cable slack; safe return. | ||
| 13 | Demonstrate managing contaminated instruments separately | Observed | Contaminated instrument returned to sterile field or contacts sterile instruments | Recognizes contamination; handles by uncontaminated portion of instrument; keeps instrument separate from sterile field. | Immediately identifies and isolates instrument without contaminating hands/field; places securely in designated contaminated-instrument location. | ||
| 14 | Post-procedure instrument handling & field breakdown | Observed | Breaks down before final count complete; sharps/unsecured instruments create injury risk; items discarded before reconciliation | Waits for completed final count; secures sharps; separates instruments and waste; breaks down field safely. | Confirms count complete before breakdown; secures sharps first; systematically clears and organizes instruments/materials while maintaining control and separation through final disposition. |
| Authors | Ian-laurel |
|---|---|
| License | CC-BY-SA-4.0 |
| Organizations | SELF, ECSACONM |
| Cite as | GSTC (2026). "SELF/Perioperative Nursing/Instrument Handling and Maintaining Sterile Field/Psychomotor Skills Practice Assessment". Appropedia. Retrieved October 3, 2026. |