Surgical Education Learners Forum/Perioperative Nursing/Setting up the Sterile Field/Psychomotor Skills Practice Assessment

Psychomotor Assessment Rubric for Setting Up the Sterile Field (ECSACONM)

Overview

This page provides a psychomotor assessment rubric for evaluating sterile field setup competency, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is a companion assessment tool to the Sterile Field Setup Skills Practice Instructions page, used by evaluators to rate student/practitioner performance on each step of sterile field preparation on a 5-point scale. The learner will need an assistant in the role of circulator to provide opening of packages and count recording, and a person filming them. This may be filmed in an actual case setup for their exam.

Purpose

To provide a standardized scoring framework for assessing clinical competency in setting up the sterile field, ranging from "Clinically Unacceptable / Not Performed" (1) to "Excellent" (5), with defined criteria at each anchor point.

Rating Scale

1 – Clinically Unacceptable / Not Performed
2 – (between 1 and 3, no separate descriptor)
3 – Clinically Acceptable / Performed
4 – (between 3 and 5, no separate descriptor)
5 – Excellent

Assessment Rubric

Step	Name	Assessment Method	1 – Clinically Unacceptable / Not Performed	3 – Clinically Acceptable / Performed	5 – Excellent
1	Gather supplies	Articulated	Not done	Done
2	Perform surgical hand scrub	Articulated	Not done	Done
3	Don sterile gown and gloves (solo)	Articulated	Incorrect, incomplete, or unsafe description of gowning and gloving	Describes the sequence of donning the sterile gown and gloves correctly, including key aseptic principles such as inside-surface handling and closed gloving	Description is complete, structured, and explicitly aseptic-focused
4	Confirm field surface is adequate and suitable	Articulated	Not done	Done
5	Open sterile table drape(s) and drape the table(s)	Observed	Touches non-sterile surfaces while handling the drape, allows the drapes to contact the table before proper placement, or loses control during unfolding	Places the drape onto the table(s) without contamination, unfolds using correct hand positioning, and achieves adequate table coverage, with minor hesitations or less controlled movements	Places the folded edge on the table without contacting non-sterile surfaces, allows the drape to open without hand contact to inner surfaces, grasps corners correctly, and unfolds smoothly to fully cover the table with controlled, deliberate movements
6	Lay out drape on Mayo stand(s) and any auxiliary items	Observed	Drape or gloved hands touch non-sterile parts of the stand, drape placed directly onto the surface before proper positioning, or drape contaminated during unfolding or application (e.g., removes hands from pockets of Mayo cover before it is fully applied)	Drapes placed without contacting non-sterile surfaces, unfolded and applied correctly, and Mayo stands and auxillary work surfaces adequately covered	Folded edge placed without touching the stand, drape opens without hand contact to inner surfaces, grasps corners to spread and drop over sides, or uses hand pockets to fully slide and pull the Mayo cover over the stands and auxillary work surfaces smoothly without any contact or contamination
7	Open surgical instrument set	Observed	Selects incorrect set, reaches over the sterile field, touches inner sterile surfaces, opens flaps in wrong sequence, or contaminates contents during receipt or transfer	Identifies the correct set, coordinates opening of outer wrap (away, sides and toward the body), receives inner wrap without crossing the field, and transfers contents onto the sterile field without contamination, with minor lapses in control or orientation	Identifies the correct set, directs outer wrap opening in correct sequence, receives inner wrap without reaching over the field, orients it correctly, and opens inner wrap by handling edges only (away, sides and toward the body)
8	Lay out sterile surgical instruments	Observed	Places instruments randomly or all of them directly onto the Mayo stand first, mixes instrument types without grouping, drags instruments across table edges, positions sharps unsafely, overcrowds the field, or creates a disorganized layout that impairs access. Skip counting and verification step.	Verifies the presence of each instrument on the checkist. Places instruments on the back table first, groups by type or sequence, arranged in a generally logical layout, positions frequently used items within reach, transfers items to the Mayo stand without contamination, and maintains a reasonably clear field.	Verifies the presence of each instrument on the checkist. Places most of the instruments on the back table first but sorts out key instruments for the mayo stand to minimize number of touches of each instrument, groups by type and sequence of use (e.g., knives, pickups, scissors, artery forceps proximally; tissue forceps distally), positions frequently used items for immediate access, places heavy items at edges and delicate items centrally, secures sharps in designated safe zones, and maintains a clear, uncluttered working area throughout. Initiates count of instruments like towel clips which can be left attached to drapes at the end of procedures.
9	Receive and organize supplies on sterile field	Observed	Reaches over the sterile field when receiving items, touches non-sterile surfaces, opens packs with incorrect flap sequence, drops or places items outside the sterile field, mixes supplies without grouping, places sharps unsecured, or creates a cluttered/unsafe layout.	Receives supplies without crossing the sterile field, uses correct edge-only handling, opens sterile packs in correct sequence (far, side and near), allows items to fall onto the sterile field without contamination, groups supplies generally by type, and maintains a functional but not fully organized layout.	Receives supplies aseptically without crossing the sterile field, handles items by edges only, verifies all expiry dates with circulator, opens packs in correct sequence (far, side and near), allows items to drop or slide onto the sterile field without contact, groups items by type, positions frequently used items within immediate reach, and arranges items in expected procedural order with a clear, uncluttered field maintained throughout.
10	Perform surgical count	Observed	Does not perform the surgical count, performs it incompletely, or fails to count instruments, sharps, and sponges systematically with the circulating nurse; does not recognize or act on a count discrepancy.	Performs the surgical count systematically with the circulating nurse according to institutional policy; counts instruments, sharps, and sponges together and confirms the count aloud. Identifies and reports any discrepancy.	Performs the surgical count systematically, accurately, and in an organized sequence with the circulating nurse; clearly confirms instruments, sharps, and sponges aloud; maintains clear accountability throughout the count; and promptly recognizes, communicates, and initiates appropriate action for any discrepancy.
11	Prepare swabs for skin prep	Observed	Does not prepare the required swabs, prepares an inadequate number, or handles/places the swabs in a way that compromises sterility or makes them unsuitable for efficient skin preparation.	Prepares an adequate number of sterile swabs for skin preparation and arranges them appropriately on the sterile field for safe and efficient use. Maintains sterility throughout preparation.	Anticipates the number and arrangement of swabs needed for the planned skin preparation; prepares and organizes them efficiently in a designated area of the sterile field while maintaining sterility; ensures they are readily accessible and arranged to support an orderly skin-preparation sequence.
12	Mount the scalpel blade and protect sharps	Observed	Does not mount the scalpel correctly, uses an unsafe technique that exposes the fingers to the blade, fails to secure the blade properly on the handle, or leaves the scalpel or other sharps in an unsafe location on the sterile field.	Mounts the scalpel correctly and securely using a safe technique without direct finger contact with the blade and places the scalpel safely in the designated container for passing.	Mounts the scalpel smoothly, securely, and with controlled technique without direct finger contact with the blade; confirms that the blade is securely seated on the handle; and immediately places the scalpel in the container for passing, positioned to support safe retrieval and handling.
13	Prepare sterile solutions and medications	Observed	Contaminates sterile field or containers during pouring or receiving of medication, fails to label medications, or handles solutions in a way that breaches asepsis or causes spillage	Pours solutions at an angle or receives medication without contaminating the sterile field, labels medications immediately, and receives solutions safely at the field edge or via scrub-held container	Pours sterile solutions at a controlled angle or receives medications without contact contamination, labels all medications immediately and accurately, and receives solutions in a stable, aseptic manner at the sterile field edge or via scrub-held container
14	Prepare drapes, gowns, and gloves for surgeon and team	Observed	Fails to open required gowns or gloves correctly, contaminates sterile packs during handling, places items outside designated sterile access areas, or does not ensure availability for the surgical team.	Opens sterile gowns and gloves without contamination and places them appropriately on the sterile field for team access. Prepares and organizes the required sterile drapes, gowns, and correctly sized gloves for the surgeon and sterile team.	Opens sterile gowns and gloves using correct aseptic technique, maintains edge-only handling without contamination, and systematically arranges them in an accessible, separate designated sterile field area for surgical team access without contaminating the table. Anticipates the required gowns and correctly sized gloves for each team member.
15	Final organization and inspection of sterile field	Articulated	Does not inspect sterile field for organization or contamination, proceeds without verifying readiness of supplies, or leaves field disorganized or potentially contaminated before team arrival	Reviews sterile field for basic organization and absence of obvious contamination, confirms most supplies are available, and states readiness to proceed	Systematically inspects sterile field for organization and contamination, ensures workspace on back table and mayo stand organization, verifies completeness and readiness of all required supplies, layout is functional and accessible, and positions self ready to begin immediately upon team arrival

Page data
Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Ian-laurel
License	CC-BY-SA-4.0
Language	English (en)
Related	0 subpages, 0 pages link here
Views	23 page views (analytics)
Created	July 13, 2026 by 2607:FEA8:3441:6400:9DB7:3F82:7765:2223
Last edit	September 3, 2026 by GSTC
Cite as	"SELF/Perioperative Nursing/Setting up the Sterile Field/Psychomotor Skills Practice Assessment". Appropedia. 2026. Retrieved September 12, 2026.
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