User:Marekpawlowski/SELF/Perioperative Nursing/Donning Sterile Gown and Gloves/Psychomotor Skills Practice Assessment

#	Step Name	1 - Clinically Unsafe	3 - Clinically Acceptable	5 - Excellent/Well Above Average
1	Gather supplies	Not done	Done
2	Open table drape and gown and glove packs	Not done	Done
3	Surgical hand scrub	Not done	Done
4	Prepare Gown	Grasps the gown incorrectly, allows it to contact non-sterile surfaces, fails to step into a clear area, or unfolds the gown unsafely.	Grasps the gown only by the inside neckline, steps into a clear area, keeps the gown away from the body and non-sterile surfaces, and unfolds it appropriately with only minor hesitations.	Grasps, positions, and unfolds the gown smoothly, confidently, and independently while consistently maintaining sterility and excellent control throughout.
5	Slide both hands and forearms into arm holes and sleeves.	Hands protrude through the sleeve cuffs, gown contacts non-sterile surfaces, or arms are inserted incorrectly.	Inserts both arms smoothly while maintaining hands inside the sleeve cuffs and keeping the gown correctly oriented with only minor technique corrections.	Performs the maneuver confidently with excellent sleeve control, maintains proper hand position throughout, and consistently preserves the sterile barrier.
6	Ask or positions self for the circulating nurse to secure the gown	Fails to communicate with the assistant, allows contamination, or extends fingers through the sleeve cuffs.	Communicates appropriately with the assistant and maintains sleeve control while the gown is secured with only minor prompting.	Demonstrates excellent communication, anticipates assistant movements, maintains sterility throughout, and coordinates the maneuver smoothly.
7	Open glove packet without contamination	Fingers emerge from the sleeve cuffs, skin contacts the glove packet or sterile field, or gloves are incorrectly oriented.	Opens the glove packet while keeping hands inside the sleeves, maintains sterility, and correctly orients the gloves with only minor adjustments.	Opens the glove packet smoothly, efficiently, and without contamination while maintaining excellent glove orientation throughout.
8	Position the first glove for donning	Drops the glove, positions it incorrectly, attempts to glove the wrong hand, or allows fingers to protrude through the sleeve cuffs.	Correctly positions the glove on the receiving sleeve, maintains proper orientation, and stabilizes the cuff while maintaining sterility.	Positions the glove precisely, maintains excellent coordination and orientation, and prepares the glove for effortless application.
9	Pull on the first glove	Tears the glove, exposes fingers before the glove covers the sleeve cuff, misaligns the glove, or uses excessive force.	Applies the glove using coordinated movements while maintaining sleeve coverage and only minor glove adjustment is required.	Applies the glove smoothly with excellent coordination, complete sleeve coverage, proper finger placement, and no unnecessary force or adjustment.
10	Adjust the first glove	Uses excessive force, leaves the sleeve bunched inside the glove, or exposes the sleeve cuff during adjustment.	Gently adjusts glove alignment and cuff position while maintaining complete glove coverage.	Makes minimal, efficient adjustments that achieve excellent alignment and cuff overlap without compromising sterility.
11	Position the second glove for donning	Drops the glove, misorients it, advances fingers through the cuff, or lowers the hands below waist level.	Correctly positions the second glove while maintaining hand position, orientation, and sterility with only minor corrections.	Positions the glove confidently with precise orientation, coordinated movements, and excellent control throughout.
12	Pull on the Second Glove	Tears the glove, exposes fingers prematurely, twists the glove, or loses sleeve coverage during application.	Applies the glove correctly using coordinated movements while maintaining sleeve coverage and proper finger placement.	Applies the glove smoothly, confidently, and independently with excellent coordination, complete sleeve coverage, and no unnecessary adjustment.
13	Adjust the second cuff and the fingers of each glove as necessary	Uses excessive force, leaves cuffs bunched, or pulls the sleeve out of the glove cuff.	Correctly adjusts both gloves, aligns the fingers, and maintains proper cuff overlap with only minor corrections.	Performs minimal, precise adjustments resulting in excellent glove fit, alignment, and unrestricted hand movement while maintaining sterility.
14	Secure the sterile gown	Performs the securing maneuver incorrectly, contaminates the gown, communicates poorly with the assistant, or turns incorrectly.	Correctly secures the gown using the appropriate method for the gown type while maintaining sterility and communicating effectively.	Secures the gown confidently and efficiently with excellent coordination, communication, and complete maintenance of sterility throughout the maneuver.
15	Final check of sterility and proceed to sterile field	Not done	Done

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