SELF/Perioperative Nursing/Suturing and Suture Removal/Psychomotor Skills Practice Assessment

Skin Suturing and Suture Removal – Assessment Rubric – Perioperative Nursing (ECSACONM)

Overview

This page provides a psychomotor assessment rubric for skin suturing and suture removal, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is the assessment companion to the Skin Suturing and Suture Removal psychomotor skills practice worksheet, used to score learner performance across the sequential steps of wound preparation, needle loading, wound edge alignment, suture placement and tying, tail trimming, dressing application, and subsequent suture removal.

Each step is scored on a five-point scale. Articulated (spoken, non-observed) steps are marked as either "Not done" or "Done." Observed steps are anchored at three levels: 1 – Clinically Unacceptable, 3 – Clinically Acceptable, and 5 – Excellent, with levels 2 and 4 available for intermediate performance. An Assistant column records the second learner's supporting actions, and a Comments column is provided for assessor notes.

Purpose

To provide a consistent, criterion-referenced tool for assessing a learner's ability to perform skin suturing and suture removal safely, ensuring aseptic technique, atraumatic tissue handling, accurate wound edge alignment, secure knot placement, appropriate tail trimming, and careful suture removal that preserves wound healing.

Psychomotor Assessment Rubric

#	Step Name	Assistant	Assessment Method	1 – Clinically Unacceptable / Not Performed	3 – Clinically Acceptable / Performed	5 – Excellent
1	Gather supplies	-	Articulated	Not done		Done
Wound suturing
2	Provide analgesia if indicated	Hands syringe/needle, monitors patient comfort	Articulated	Not done		Done
3	Clean and prepare the wound site	Pours saline/antiseptic, manages waste, and holds light	Observed	Cleans the wound incorrectly, contaminates the wound, cleans in the wrong direction, or fails to allow antiseptic to dry before closure.	Cleans the wound appropriately using aseptic technique with only minor inefficiencies that do not compromise wound preparation.	Cleans the wound confidently using excellent aseptic technique, removes debris appropriately, maintains tissue integrity, and prepares an optimal wound bed for closure.
4	Load needle onto needle holder	-	Observed	Grasps the needle incorrectly, loads it insecurely, or demonstrates unsafe instrument handling that interferes with controlled suturing.	Loads the needle securely with correct orientation and adequate control, requiring only minor repositioning.	Loads the needle confidently with correct grasp point, optimal orientation, excellent stability, and efficient instrument control throughout.
5	Align wound edges	-	Observed	Crushes tissue, poorly aligns wound edges, creates excessive tension, or leaves wound edges inverted or uneven.	Aligns wound edges appropriately with acceptable tissue handling and adequate approximation.	Demonstrates excellent atraumatic tissue handling with precise anatomical alignment, consistent edge eversion, and balanced tissue tension throughout.
6	Place sutures	Blots blood gently, maintains visibility, and helps keep patient still	Observed	Needle placement is inconsistent or unsafe, tissue bites are uneven, spacing is poor, or tissue trauma compromises wound closure.	Places sutures with generally consistent spacing, depth, and approximation, with only minor technical imperfections.	Places sutures smoothly and efficiently with excellent needle control, symmetrical bites, consistent spacing and depth, minimal tissue trauma, and excellent wound approximation.
7	Tie sutures	-	Observed	Knot sequence is incorrect, knots are insecure or excessively tight, tissue is strangulated, or wound edges remain poorly approximated.	Forms secure knots with acceptable technique and appropriate wound approximation despite minor inefficiencies.	Performs instrument ties smoothly with excellent hand coordination, secure flat knots, consistent tension, and optimal wound approximation without tissue trauma.
8	Cut suture tails	Assists by cutting suture tails	Observed	Cuts tails excessively short or long, loosens the knot during cutting, or compromises wound closure.	Cuts suture tails to an appropriate length while maintaining knot security, with only minor inefficiencies.	Cuts suture tails efficiently while maintaining complete knot stability, appropriate tail length, and excellent instrument control.
9	Apply dressing after suturing	-	Observed	Contaminates the dressing, selects an inappropriate dressing, or leaves the wound inadequately protected.	Applies an appropriate dressing securely with complete wound coverage and only minor handling imperfections.	Applies the dressing confidently using excellent aseptic technique with precise positioning, secure fixation, and complete wound protection.
Suture removal
10	Clean wound before suture removal	Holds gauze/waste and assists with soaking crusted areas	Observed	Cleans aggressively, contaminates the wound, causes tissue trauma, or fails to adequately expose the sutures.	Cleans the wound appropriately using aseptic technique with only minor inefficiencies.	Cleans the wound gently and systematically using excellent aseptic technique while preserving healing tissue and maximizing visualization of each suture.
11	Remove sutures carefully	-	Observed	Cuts the wrong portion of the suture, pulls contaminated suture material through tissue, causes wound trauma, or leaves retained sutures.	Removes sutures safely using appropriate technique with only minor inefficiencies that do not compromise the wound.	Removes sutures smoothly and atraumatically with excellent forceps handling, precise cutting, continuous wound assessment, accurate suture counting, and minimal patient discomfort.
12	Reassess wound after removal	-	Articulated	Not done		Done

References

Page data
Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Ian-laurel
License	CC-BY-SA-4.0
Organizations	SELF, ECSACONM
Language	English (en)
Related	0 subpages, 1 pages link here
Views	2 page views (analytics)
Created	July 29, 2026 by Ian-laurel-1
Last edit	July 29, 2026 by StandardWikitext bot
Cite as	Ian-laurel-1 (2026). "SELF/Perioperative Nursing/Suturing and Suture Removal/Psychomotor Skills Practice Assessment". Appropedia. Retrieved August 2, 2026.
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