Donning a sterile surgical gown is one of the most critical infection control practices in any operating room. However, gowning properly requires meticulous technique and care. Even small errors in sterile gowning can lead to contamination and increased surgical site infection risk.
As a medical professional, understanding the ins and outs of sterile gowns is essential. This guide will provide 15 must-know tips and best practices for proper use of sterile surgical gowns.
Importance of Proper Gowning Technique
Maintaining sterility during gowning and surgery is paramount. Contaminated gowns can harbor bacteria that get transferred to the surgical site. This puts patients at risk of developing surgical site infections – a major cause of morbidity and mortality. Meticulous sterile technique when putting on and wearing gowns is crucial.
Choosing the Right Gown Material
Not all gown materials provide the same level of barrier protection. Synthetic nonwoven fabrics like spunbond-meltblown-spunbond (SMS) are more protective than natural fabrics like cotton. SMS gowns have a complex layered structure that prevents passage of particles and fluids. Other factors like liquid repellency also affect how well gown materials resist penetration.
Understanding AAMI Gown Levels
The Association for the Advancement of Medical Instrumentation (AAMI) sets performance standards for surgical gowns based on liquid barrier protection. Level 4 gowns provide the highest level of protection, blocking virus-sized particles and fluids under pressure. Level 1 gowns offer the least protection for low-risk cases. Selecting the right AAMI level gown for the surgery is important.
Donning Sterile Gowns Properly
Putting on sterile gowns properly is vital. The gown should be donned carefully per the manufacturer’s instructions, ensuring the inside remains sterile. Any non-sterile surfaces or hands should not contact the inside of the gown. Assistance may be needed to put gowns on correctly.
Maintaining Sterility During Gowning
While donning gowns, care should be taken to not contaminate the sterile inner surface. Opening gowns aseptically, avoiding unnecessary movement, and using careful technique preserves sterility. Gowns should not be shaken open or handled excessively.
Proper Gloving Techniques
Gloves should be donned after gowning using the proper sterile technique. Ensure gown cuffs are pulled over gloved hands. This crucial step seals the barrier protection. Gloves should not be put on before gowning.
Ensuring Full Coverage of Gowns
Gowns must fully wrap around the body with complete front and back coverage. Openings or gaps can allow bacteria entry. Coverage should extend from the neck to mid-calf. Using correct gown sizes helps prevent exposure.
Tying Gowns Securely
Sterile gown ties should be secured at the waist and neck to prevent any openings. Ties should be tied securely but comfortably using a bow or double square knot. Loose ties can compromise the critical neck closure. Assistance may be needed.
Moving Safely After Gowning
After sterile gowning, mobility should be limited to prevent accidental contamination. Raising arms overhead should be avoided. Careful movements and assistance from unsterile personnel can help prevent breaches.
Preventing Contamination During Surgery
While operating, maintaining sterile technique is essential. Leaning or pressing against non-sterile surfaces should be avoided. Sterile areas of gowns should not contact unprepared skin. Careful body positioning prevents contact contamination.
Doffing Gowns Without Compromising Sterility
Removing gowns post-surgery also carries risks. To avoid contaminating sterile surgical fields, gowns should be removed slowly and deliberately. Fronts should be pulled away from the body without rapid motions. Assistance may be warranted.
Disposing of Used Gowns Properly
After removal, used contaminated gowns should be discarded immediately in designated containers. Proper handling and disposal prevents disease transmission. Reuse and extended wear should be avoided with single-use disposable gowns.
Storing Unused Gowns Correctly
Unused sterile reserve gowns must be stored properly between uses. They should be protected from moisture, sunlight, and contamination inside dust covers or cabinets. Manufacturer instructions for in-between storage should be followed.
Monitoring Gowns for Integrity and Expiration
Gowns should be inspected prior to use for holes, tears or flaws that could impair barrier protection. Expiration dates should also be checked as gown material can degrade over time. Damaged or expired gowns should not be worn.
Complying With Hospital Gowning Policies
Healthcare facilities establish sterile gowning protocols aligned with guidelines. Following hospital policies and procedures ensures consistency. Periodic competency assessments help identify needs for technique retraining.
By understanding and implementing proper sterile gowning principles, healthcare workers create a formidable barrier against surgical site infections. A strict culture of sterile technique protects patients and improves outcomes. Sterile surgical gowns worn correctly are a key infection prevention safeguard in the OR.
Selecting the optimal sterile surgical gown material is crucial for maintaining sterility in the OR. Not all fabrics provide equivalent barrier effectiveness against microbes, fluids, and particles. Understanding key properties and performance factors allows medical staff to choose the right materials for their gown needs.
Traditionally, most surgical gowns were made of cotton or linen. However, natural fiber fabrics allow more penetration of liquids and microorganisms compared to synthetic materials. Modern gowns are commonly constructed using nonwoven polypropylene or other synthetic fabrics which create a more impermeable barrier.
One of the most common and effective materials for sterile gowns is spunbond-meltblown-spunbond (SMS). This is a specialized nonwoven polypropylene with a triple-layer composition. The inner meltblown layer acts as a filter that prevents passage of particles as tiny as bacteria and viruses. The sturdy spunbond outer layers provide strength and durability.
Another advanced gown material is film laminates which integrate a polypropylene film into the fabric. These create an even greater barrier against fluid penetration. However, film laminates tend to be less breathable and flexible than SMS fabrics.
When selecting surgical gown materials, liquid repellency is a key factor. Repellency determines how well a fabric resists penetration by splashes, sprays, and fluids. Some materials have proprietary enhancements to boost repellency and wetting resistance.
Breathability is also important for comfort. Microporous films and nonwovens allow more air permeability and ventilation compared to impermeable materials. However, highly breathable fabrics may compromise barrier effectiveness.
The Association for the Advancement of Medical Instrumentation (AAMI) ranks surgical gown materials into four levels based on their tested barrier performance. Level 4 materials like SMS provide the highest level of protection. Level 1 materials like spunlace offer the least protection for lower risk cases.
Ideally, sterile gown material should be optically opaque to prevent show through. Yarns and textile finishes can enhance opacity. Gowns that are too transparent necessitate undergarments adding cost and discomfort.
Lastly, factors like strength, abrasion resistance, antistatic properties, and flammability are also important. Rigorous manufacturing quality controls ensures reliable material performance and durability.
By understanding attributes of surgical gown materials, healthcare facilities can match the appropriate protective level to the task. The highest risk surgeries require maximum barrier performance Level 4 gowns. Whereas basic exams may only need Level 1. Properly specifying materials maintains sterility and safety.
With numerous innovations in textiles and nonwovens, the choices of high quality gown materials continue to expand. Keeping updated on the latest technical advances allows facilities to take advantage of improved protection, comfort, and cost.
Ultimately, selection of the optimal sterile surgical gown material relies on a careful analysis of protective properties balanced with comfort, cost, and other factors. Knowledge of fabrics, barrier performance, and production quality ensures the right choice is made.
Understanding AAMI Gown Levels
When it comes to personal protective equipment in healthcare settings, surgical gowns are a crucial barrier against infectious diseases and bodily fluids. Not all gowns are created equal, however. There are different levels of protective gowns as defined by the Association for the Advancement of Medical Instrumentation (AAMI). Understanding these AAMI gown levels can help medical professionals select the appropriate protective apparel for specific procedures and risks.
Level 1 – Minimal Risk Gowns
AAMI Level 1 gowns provide minimal protection and are suitable for basic isolation precautions. These gowns are designed for procedures and tasks involving minimal amounts of blood, fluid spray or aerosols. Examples include standard physical exams or vital sign checks. Level 1 gowns provide coverage to the shoulders and arms, with full back closure. They are constructed of lightweight materials that are fluid resistant.
Level 2 – Low Risk Gowns
AAMI Level 2 gowns provide low levels of protection for procedures where moderate to light amounts of fluid spray or aerosols are produced. This includes arterial blood draws, insertion of IVs or catheters, lumbar punctures, and suturing. Level 2 gowns extend below the knees with full back closure and sleeves that fully cover the arms. They are made of materials that are fluid resistant and provide increased durability and reliability.
Level 3 – Moderate Risk Gowns
AAMI Level 3 gowns are suitable for moderate risk situations involving larger amounts of blood, bodily fluids or infectious materials. Examples are major surgeries, vaginal delivery, trauma treatment, and orthopedic surgery. Level 3 gowns fully cover the arms and legs, with cuffed sleeves and elastic bands at the neck, waist and wrists. They provide 360-degree protection with overlap in the back. Materials are fluid resistant and durable.
Level 4 – High Risk Gowns
Level 4 gowns provide maximum protection for procedures where heavy amounts of fluid, spray and aerosols are produced. This includes long, complex surgeries with moderate blood loss, major orthopedic surgery, heart surgery, cesarean sections, and vascular procedures. Level 4 gowns fully wrap around the back and overlap with 360-degree coverage. They have durable reinforced seams, full sleeve cuffs, and double-layer fabric in critical areas. Materials are highly fluid resistant.
Your Guide to Sterile Surgical Gowns: 15 Must-Know Tips for Medical Professionals
Sterile surgical gowns are a vital component of infection control in the operating room. When worn correctly, they create an effective barrier that minimizes the transfer of microorganisms between non-sterile and sterile areas. Here are 15 essential tips for medical professionals on proper selection, use, and care of sterile gowns:
1. Choose the right gown level
Select a sterile surgical gown appropriate for the procedure’s level of exposure risk, using AAMI standards as a guide. Higher fluid volumes require higher gown levels.
2. Consider liquids and pathogens
Factor in the types of fluids and potential pathogens involved. Gowns with highly protective materials are ideal for procedures with heavy volumes or highly infectious fluids.
3. Get the right size
Gowns should fit correctly and not constrict movement. Consider body size, gown dimensions, preferred looseness, and required coverage.
4. Tie securely at neck and waist
Proper tying of gown neck and waist ties ensures maximum overlap and minimizes potential openings. Use a secure double square knot.
5. Keep cuffs covered
Cuffed sleeves with fitted wrists offer added protection. Keep cuffs fully covered by glove cuffs throughout procedures.
6. Don carefully to maintain sterility
To prevent contamination, gown must only contact sterile inner surface during donning. Avoid contact with outer surface.
7. Cover torso front and back
Gowns should fully cover front and wrap to back with overlapping fabric for 360-degree protection.
8. Keep fabric off the floor
Never allow gown fabric to drop or brush the floor after donning to avoid picking up contaminants.
9. Move carefully to avoid tears
Careful and deliberate movements are key to avoid rips, tears or openings during procedures. Sudden motions can compromise the gown.
10. Keep arms raised during use
Using proper sterile technique with hands and arms up away from the body ensures the gown stays correctly positioned.
11. Remove gown slowly and properly
Unfasten or untie ties slowly, peel gown gently away from neck and shoulders, and roll inside-out to contain contaminants.
12. Dispose properly after use
Used disposable gowns are contaminated medical waste requiring proper handling and disposal protocols.
13. Inspect for defects
Routine checks ensure gowns remain defect-free. Visually examine for holes, fraying, seam separation, or material degradation.
14. Handle and store with care
Proper handling and storage maintains gown integrity and sterility. Fold, stack, or hang per package directions to avoid damage.
15. Follow all aseptic protocols
Adhere fully to sterile procedures when gowning and performing surgical procedures to minimize contamination risks.
With the right selection, usage, and care, sterile surgical gowns provide indispensable protection for patients and staff during invasive procedures. Following these essential tips will maximize the barrier effectiveness of sterile gowns in the operating theatre.
Donning Sterile Gowns Properly
Donning a sterile surgical gown properly is a vital skill for medical professionals. Proper sterile gowning technique establishes a crucial barrier against infectious microorganisms in the operating room. When putting on a sterile gown, meticulous aseptic technique is essential to prevent contamination.
1. Inspect the gown first
Before gowning, inspect the sterile wrap carefully for holes or tears that could compromise sterility. Also check expiration or packaging date. Only use undamaged, in-date gowns.
2. Perform hand hygiene
Wash hands thoroughly with soap and water or alcohol-based sanitizer. This removes microorganisms and ensures clean hands before gowning.
3. Face the back opening
The opening ties should be facing your back. This positions the gown correctly for proper coverage front and back.
4. Open the outer wrap
Untie or unfold outer protective wrap, touching only the exterior surface. Inner surface should remain sterile.
5. Open inner wrap
Using only the corners or edges, gently pull open inner sterile wrap, touching only inside or sterile parts of gown.
6. Unfold gown touching only inside
Let gown unfold and drop down, touching only inner sterile surfaces. Do not allow hands to contact outer surface.
7. Insert arms into sleeves
Keeping arms elevated, carefully guide arms into sleeves only contacting inside lining. Avoid dragging fabric across body.
8. Secure neck and waist ties
Tie top neck ties, then waist or side ties using a snug double square knot. Cover all clothing including shoes.
9. Ensure back overlap
Gown fabric should fully overlap at back with no gaps. If available, have assistant check for gaps and complete coverage.
10. Avoid fabric drag and flaring
Prevent gown from dragging, trailing or flaring out. Keep fabric close to body with deliberate movements.
11. Cover cuffs with gloves
When donning sterile gloves, pull glove cuffs securely up over gown cuffs for added protection.
12. Keep hands up and away from body
Maintain sterility during procedures by holding hands/arms up and out, away from gown front.
13. Turn away to remove gown
When finished, turn away from sterile field. Untie waist first, then neck ties. Peel gown down and away to remove.
14. Dispose of properly
Used gowns are contaminated and must be discarded in designated biohazard waste receptacles.
15. Wash hands again
Perform hand hygiene once more after removing and disposing of used gown.
Your Guide to Sterile Surgical Gowns: 15 Must-Know Tips for Medical Professionals
Sterile surgical gowns are a vital component of infection control in the operating room. When worn correctly, they create an effective barrier that minimizes the transfer of microorganisms between non-sterile and sterile areas. Here are 15 essential tips for medical professionals on proper selection, use, and care of sterile gowns:
1. Choose the right gown level
Select a sterile surgical gown appropriate for the procedure’s level of exposure risk, using AAMI standards as a guide. Higher fluid volumes require higher gown levels.
2. Consider liquids and pathogens
Factor in the types of fluids and potential pathogens involved. Gowns with highly protective materials are ideal for procedures with heavy volumes or highly infectious fluids.
3. Get the right size
Gowns should fit correctly and not constrict movement. Consider body size, gown dimensions, preferred looseness, and required coverage.
4. Tie securely at neck and waist
Proper tying of gown neck and waist ties ensures maximum overlap and minimizes potential openings. Use a secure double square knot.
5. Keep cuffs covered
Cuffed sleeves with fitted wrists offer added protection. Keep cuffs fully covered by glove cuffs throughout procedures.
6. Don carefully to maintain sterility
To prevent contamination, gown must only contact sterile inner surface during donning. Avoid contact with outer surface.
7. Cover torso front and back
Gowns should fully cover front and wrap to back with overlapping fabric for 360-degree protection.
8. Keep fabric off the floor
Never allow gown fabric to drop or brush the floor after donning to avoid picking up contaminants.
9. Move carefully to avoid tears
Careful and deliberate movements are key to avoid rips, tears or openings during procedures. Sudden motions can compromise the gown.
10. Keep arms raised during use
Using proper sterile technique with hands and arms up away from the body ensures the gown stays correctly positioned.
11. Remove gown slowly and properly
Unfasten or untie ties slowly, peel gown gently away from neck and shoulders, and roll inside-out to contain contaminants.
12. Dispose properly after use
Used disposable gowns are contaminated medical waste requiring proper handling and disposal protocols.
13. Inspect for defects
Routine checks ensure gowns remain defect-free. Visually examine for holes, fraying, seam separation, or material degradation.
14. Handle and store with care
Proper handling and storage maintains gown integrity and sterility. Fold, stack, or hang per package directions to avoid damage.
15. Follow all aseptic protocols
Adhere fully to sterile procedures when gowning and performing surgical procedures to minimize contamination risks.
With the right selection, usage, and care, sterile surgical gowns provide indispensable protection for patients and staff during invasive procedures. Following these essential tips will maximize the barrier effectiveness of sterile gowns in the operating theatre.
Maintaining Sterility During Gowning
Donning a sterile surgical gown is a critical process for medical professionals. Contamination during gowning can completely defeat the purpose of wearing sterile attire in the first place. As a nurse, doctor, or technician preparing for a procedure, you carry immense responsibility to prevent infections and procedural complications. How exactly can you guarantee sterile technique each and every time you gown up?
This guide offers 15 must-know tips and best practices for flawless sterile gowning. Follow these research-backed recommendations to keep your patients safe and stay confident in your sterile field.
1. Verify Packaging Integrity
Before opening any sterile gown package, always inspect it closely. Make sure the packaging is dry, intact, and undamaged. If moisture, holes, or compromised seals are present, the contents may no longer be sterile. Do not attempt to use a gown from defective packaging.
2. Know Your Gown Type
Understand the type of sterile gown you are using, as donning procedures vary. Is it a standard tie gown, a wraparound closure, or an overhead/poncho style? Consult the manufacturer guidelines for your specific gown model if unsure of proper wear and fit.
3. Perform Hand Hygiene
Rigorously wash your hands before gowning, using antimicrobial soap and water or alcohol-based sanitizer. Bacteria and viruses on your hands can easily contaminate your gown during the donning process. Proper hand hygiene helps ensure you begin with maximally clean hands.
4. Face the Back Opening
After opening the gown package, face the back opening rather than the front. This prevents inadvertent contact between your body and the sterility of the gown’s front surface while donning.
5. Unfold Without Contamination
Unfold the gown using only the outside edges or handling portions. Do not contact the inside sterile surface that will rest against your body. Flick your wrists downward as you unfold to prevent inward contamination.
6. Secure Neck and Waist Ties
If your gown uses back ties, secure the neck tie first followed by the waist tie. Tie firmly but not too tightly. Assistance from another person is ideal if available. Ensure ties remain secured but untwisted after fastening.
7. Consider Gloves and Face Protection
Does your protocol call for sterile gloves and a face shield or mask? If so, don these immediately after securing back closure ties. Avoid inadvertently touching non-sterile surfaces after putting on sterile gloves.
8. Untie Only When Necessary
Never untie closure ties after initially securing them. This can lead to breakdown of the sterile field. Only untie or loosen ties if adjusting fit or donning other sterile gear like gloves over the cuffs.
9. Wrap Around the Back
For wraparound closure styles, your assistant should grasp the outside seam of the gown at the back waist. Pull it around your body without allowing the inside sterile surface to make contact.
10. Overlap at the Back
The two flaps of a wraparound closure gown should overlap completely at your back. The ties or adhesive strips can then be secured. This ensures 360-degree sterility coverage.
11. Keep Arms Raised
Regardless of gown style, keep your arms raised slightly away from your body during the donning process. This helps prevent inadvertent contact between your arms and torso and the sterile gowning surfaces.
12. Avoid Reaching Back
Do not reach around your back after putting on a sterile gown, which can lead to contamination. Have an assistant handle all closure ties and ensure proper fit.
13. Prevent Billowing
Once your gown is secured, avoid allowing excess material to billow outward away from your body. This can allow convection currents to penetrate beneath the gown and compromise sterility.
14. Handle Only Outside Surfaces
After you are fully gowned, touch only the outside surfaces of the gown if adjustments are needed. Never handle the inside sterile surfaces which face your body underneath.
15. Doff Properly
Removing a soiled gown improperly can lead to contamination. Carefully peel gown away from your body, only touching the outside surfaces. Do not allow soiled gown to contact your clothing underneath during removal.
By meticulously following sterile technique principles during every phase of gown donning, medical professionals can ensure operating room sterility and positive patient outcomes. Use this checklist of gowning best practices to prevent breakdowns in aseptic protocols.
Proper Gloving Techniques
Donning sterile gloves is a vital process for maintaining asepsis before medical procedures. However, contaminated gloves defeat their entire purpose. As a healthcare provider, you must master proper gloving techniques to keep your patients safe.
This comprehensive guide outlines crucial best practices for flawless sterile gloving. Follow these clinically-backed recommendations to prevent errors and uphold your sterile field with confidence.
1. Select Appropriate Gloves
Choose the right sterile gloves for your procedure in terms of fit, length, material, etc. Ill-fitting or improper gloves increase risk of tears and contamination. Consult your protocol and patient needs.
2. Inspect Packaging
Examine glove packaging carefully before opening. Make sure it is intact, undamaged, dry, and within the manufacturer’s expiration date. Do not use compromised or defective packages.
3. Perform Hand Hygiene
Rigorously wash hands and wrists with antimicrobial soap prior to gloving. Removing dirt, oils, and microbes minimizes contamination risk during donning.
After washing hands, avoid touching environmental surfaces before gloving. This prevents re-contaminating your freshly sanitized hands right before donning.
5. Open Packaging Aseptically
Use proper aseptic technique when opening packaging. Do not handle the inner sterile surfaces contacts your skin. Allow an assistant to present the gloves one at a time.
6. Insert Hands Smoothly
Insert each hand into its glove gently without touching outer glove surfaces. Use a smooth, singular motion to prevent folding or tearing the glove.
7. Adjust Fit
Make any needed adjustments in fit by grasping the glove cuff and smoothing material over each finger. Avoid tugging on the glove body and fingertips.
8. Avoid Recontamination
Do not allow gloved hands to touch non-sterile surfaces like your arms, clothing, etc. This can transfer bacteria right back onto your gloves.
9. Wait for Double Gloving
If double gloving, put on both sets of gloves at the very beginning, before any other PPE or sterile attire. This prevents contaminating inner gloves during later steps.
10. Monitor Integrity
Visually inspect gloves for small holes or tears immediately after donning. Also check integrity frequently during lengthy procedures for late onset defects.
11. Avoid Long Fingernails
Keep natural fingernails neat and closely trimmed before gloving. Long nails increase risks of glove puncture and are difficult to thoroughly clean underneath.
12. Remove Jewelry
Take off all hand and arm jewelry prior to gloving. Rings, bracelets, watches can all compromise glove integrity and harbor microbes.
13. Change when Indicated
Promptly change contaminated, torn or overly soiled gloves during a case. Never try to sterilize used gloves or attempt glove “decontamination.”
14. Avoid Reuse
Never reuse disposable gloves between patients or procedures, even if they seem intact. Undetected micro-defects can harbor infectious pathogens.
15. Doff Properly
Remove used gloves by peeling them off from the inside, turning them inside-out. Dispose of immediately in proper biohazard receptacles.
By fastidiously adhering to clinical best practices for sterile gloving, healthcare workers can maximize patient safety and infection control. Use this evidence-based checklist to ensure flawless gloving technique for every procedure.
Ensuring Full Coverage of Gowns
Achieving complete coverage with sterile surgical gowns is imperative for reducing infection risks during procedures. However, improper fit or poor donning technique can lead to inadvertent skin or clothing exposure.
This guide provides critical tips for healthcare personnel to ensure flawless head-to-toe coverage when wearing sterile gowns in the OR. Follow these evidence-based recommendations for optimal aseptic practices.
1. Select the Right Size
Choose a gown size that allows complete wrap-around coverage without being overly loose or tight. Consider your own body dimensions as well as the style and fit of the specific gown model.
2. Face the Back Opening
After opening the sterile package, face the back opening rather than the front. This prevents contact between your body and the gown’s sterile interior as you put it on.
3. Secure Neck Ties First
For back-closure gowns, tie the neck opening first before securing the waist. This ensures the gown collar properly covers your shoulders without gaping.
4. Check Arm Coverage
With your arms still raised, ensure the gown sleeves completely cover your arms down to the wrists when standing straight.
5. Verify Wrist Overlap
Gown cuffs should completely overlap any isolation gown sleeves on your forearms with no exposed skin visible.
6. Look For Gapping
Visually inspect for any gaping or separation between gown edges, especially around the neck, shoulders and arms. Have an assistant reshape and adjust ties to maintain coverage.
7. Prevent Billowing
Avoid allowing excess gown material to billow outward from your body. This can allow convection currents to get under the gown and lift it off your skin.
8. Check Back Overlap
For wraparound gowns, ensure back flaps generously overlap each other without any space between. Side-ties or adhesive strips should then be firmly secured.
9. Face Away From Assistants
When putting on isolation gowns over your sterile surgical attire, face away from assistants to prevent contact contamination while they fasten ties or adhesive strips.
10. Ensure Ankle Coverage
Surgical gown length should extend to mid-calf or completely cover your shoes and ankles when standing straight.
11. Consider Shoe Covers
Wear designated OR shoe covers if sterility protocols call for complete foot coverage beyond standard surgical gown length.
12. Check Fit While Moving
Walk around and go through a range of motions after donning gowns to identify any pulling, separation or skin exposure that may occur with body movements.
13. Keep Arms Raised
Keep hands and arms extended slightly away from the body during gowning to prevent contact between your limbs and torso and the sterile inner gown surface.
14. Inspect Again Before Entry
Perform a final head-to-toe visual check after fully donning sterile attire and immediately before entering the sterile field to verify flawless coverage.
15. Adjust Only From the Front
If adjustments are needed after gowning, carefully reshape the gown by grasping only the outer non-sterile surfaces. Avoid reaching beneath or around the back side.
Meticulous sterile gowning technique is crucial for reducing procedural infection risks. Follow these evidence-based recommendations to ensure full head-to-toe coverage of your sterile surgical attire.
Tying Gowns Securely
Properly securing the ties of sterile surgical gowns is imperative for maintaining aseptic technique. However, loose, tangled, or poorly fastened ties can lead to inadvertent gown flap separation and breaks in sterility.
This comprehensive guide provides critical tips for flawlessly tying surgical gowns. Follow these evidence-based recommendations to keep your sterile field intact.
1. Tie Neck First
For back-closure gowns, always secure the neck ties before tying or fastening the waist. This prevents gapping exposure as you finish donning the gown.
2. Tie Firmly But Not Too Tight
Tie gown ties snugly enough to keep the gown secure against your body without constricting movement or circulation. The knot should lay flat.
3. Face Away From Assistant
Stand facing away from assistants while they tie your gown to prevent accidental contact with your scrubbed front.
Instruct assistants to gently tension both sides of the tie equally when knotting to prevent lopsided tightness or uneven flap coverage on one side.
5. Keep Ties Flat
Make sure tied knots lay flat against your gown with no folded or twisted portions. Twisted ties can press openings into adjacent gown material.
6. Avoid Catching Ties in Gown
Assistants should take care not to catch the tie ends inside the wrapped gown flaps when knotting. Exposed ties can snag and unravel.
7. Check Range of Motion
After securing all ties, move through a full range of motions to ensure you can move freely without the gown pulling open anywhere.
8. Retie Loosen Knots Promptly
If a gown knot begins to loosen noticeably during a procedure, have an assistant promptly retie it to restore snugness before gaping occurs.
9. Do Not Remove Used Ties
Never attempt to completely remove soiled gown tie strings for reuse. Cutting ties compromises the protective gown flaps. Use new tie strings only.
10. Handle Ties Gently
Avoid tugging, pulling or applying excessive tension to tie strings when adjusting gown fit. This can damage the ties or tear gown material.
11. Check After Removing Gloves
Anytime sterile gloves are removed during a procedure, re-inspect gown ties and knots to ensure they remain snugly fastened and flat.
12. Retie Before Breaking Sterility
If temporarily stepping out of the sterile field during a case, have all gown ties checked and firmly retied before re-entering to restore knot integrity.
13. Prevent External Contact
Make sure untied gown tie string ends only make internal contact with outer non-sterile gown surfaces. Do not allow to dangle or contact external unsterile surfaces.
14. Handle Single Ties Together
When gowns have two ties at one location, assistants should handle and tie them in parallel as a single unit to ensure equivalent snugness.
15. Check After Cover Gown Donning
After applying isolation or cover gowns atop your primary sterile attire, re-verify neck and waist tie knots remain fully fastened and flush.
Following meticulous practices for sterile gown knot tying and inspection helps ensure procedural asepsis and patient safety. Refer to this evidence-based protocol to prevent gown tie failures.
Moving Safely After Gowning
Maintaining sterility when moving after surgical gowning requires vigilance. Even normal motions can cause separation or flapping that destroys the sterile field beneath the gown.
This guide outlines crucial tips for aseptic movement and control after sterile gowning. Follow these evidence-based techniques to keep your gown’s coverage intact.
1. Avoid Quick Movements
Move slowly, gently, and deliberately at all times after donning sterile attire. Sudden movements or pivoting can lead to gaping and loss of coverage.
2. Face the Same Direction
Avoid turning your back to assistants after gowning. Keep facing the same direction until at the surgical table to maintain control of the gown.
3. Keep Hands Above Waist
When standing, keep hands held above waist level to prevent inadvertently lifting gown material and exposing skin underneath.
4. Stay Close to Table
Approach the surgical table closely before attempting to sit down. Sitting prematurely can pull gowns upward and compromise coverage.
5. Check Ankles Before Sitting
Before bending knees to sit, ensure surgical gown length fully covers your shoes and ankles to prevent exposure as hemlines rise.
6. Sit Deliberately
Bend your knees smoothly and sit down gently in a controlled fashion. Avoid sudden dropping motions that can dislodge gown material.
7. Arrange Gown Carefully
Once seated, carefully smooth and drape your surgical gown material ensuring it lays properly without trapped folds or pulled areas.
8. Keep Chest Upright
Maintain upright posture when standing and sitting. Bending forward can cause neck and shoulder gapping.
9. Reach Out Slowly
Extend your arms gradually to prevent sudden tugging that disrupts sleeves and pulls gown material.
10. Keep elbows tucked in
When sitting, keep elbows relatively tucked against your body. Outstretched elbows can pop sleeve cuffs open.
11. Move a leg at a time
If repositioning your legs while seated, lift and move one leg at a time. Moving both legs simultaneously can disrupt your gown.
12. Scoot Don’t Stand to Move
Scoot along the surface of your seat if you must change position. Avoid repeatedly standing up and sitting back down.
13. Raise Both Hands Equally
When reaching both hands overhead, lift them in parallel at an even pace. Lopsided or asymmetric movements can cause imbalanced gapping.
14. Take Small Steps
Use small deliberate steps if walking is necessary to optimize gown control and prevent striding-induced gaps.
15. Keep Arms Away From Body
Hold your arms slightly extended out from your torso when moving about to prevent contact between limbs and your gown’s sterile surface.
Meticulous motion practices and body awareness are key after surgical gowning. Refer to this protocol when moving to ensure optimal aseptic technique and sterility maintenance.
Preventing Contamination During Surgery
Vigilance regarding sterile technique must be maintained throughout entire surgical procedures. Any inadvertent contamination of gowns or sterile fields could have devastating consequences.
This guide provides critical tips for preventing intraoperative contamination events. Follow these evidence-based recommendations to sustain flawless aseptic practices from first cut to final closure.
1. Wear Double Gloves
Apply two sets of sterile surgical gloves from the very start to allow quick outer glove changes during cases if contact contamination occurs.
2. Limit What is Opened
Open only essential sterile supplies needed for the immediate surgical steps. The less opened and exposed, the lower the contamination risk.
3. Pass Only in Basins
Handle all sterile items with care and pass only in sterile basins to prevent contact with unsterile surfaces.
4. Keep Transferring Hands Away
When passing sterile items between team members, keep inactive hands well away to avoid inadvertent contact.
5. Turn Intentionally
Pivot your body slowly and with control when turning. Avoid quick uncontrolled spins that can flap gown material.
6. Keep Elbows Tucked In
Keep elbows close to your torso when seated at the field. Outstretched elbows pop sleeve cuffs open.
7. Drape Carefully
When prepping and draping the patient, avoid haphazard flinging of drapes. Unfurl smoothly and gently into position.
8. Check Head Drapes
Confirm face and head drapes are securely bordered with towels to absorb condensation and prevent dripping into the sterile field.
9. Handle Tubing Meticulously
When arranging tubes and lines, be extremely careful to avoid contact between tubing ends and nonsterile surfaces.
10. Keep Devices Low
Adjust IV poles, equipment booms, and other apparatus to their lowest safe heights. Suspended items can drip into the field.
11. Watch Body Mechanics
Be mindful of positioning arms, elbows, and shoulders to avoid contact between your gown and furniture edges or nonsterile surfaces.
12. Keep Sterile Items Covered
Cover sterile instrument trays, basins, and prep supplies with sterile towels when not actively in use to prevent airborne contamination.
13. Segregate Used Items
Make sure contaminated materials like blades, sponges, and suction canisters are safely relegated to the nonsterile field away from sterile areas.
14. Drape Around Assistants
Form sterile boundaries with drapes around any non-scrubbed assistants reaching into the field to protect adjacent sterile areas.
15. REDO Sterile Prep if Needed
If any significant contamination event occurs, stop and re-prep, re-drape, and redo antiseptic skin prepping as needed.
Meticulous sterile practices and vigilance are essential for avoiding intraoperative contamination. Use this checklist to ensure flawless aseptic technique throughout surgical procedures.
Doffing Gowns Without Compromising Sterility
Removing soiled surgical gowns properly is critical to avoid contaminating previously sterile sites or breaching remaining sterile fields.
This guide provides key evidence-based recommendations for doffing sterile gowns flawlessly. Meticulously follow these steps to maintain aseptic technique.
1. Inspect for Visible Contamination
Closely examine all outer gown surfaces for any gross contamination like blood or body fluids before initiating removal.
2. Stand Next to Trash Receptacle
Position yourself adjacent to a suitable trash container before beginning gown removal to allow immediate disposal.
3. Peel Away From Body
Untie or unfasten gown closures then pull gown away from body using only the outer surfaces. Avoid touching scrubs or skin underneath.
4. Touch Only Outer Surfaces
As you remove the gown, handle only the outer contaminated surfaces. Do not contact or grasp any inner areas touching your body.
5. Invert Sleeves
When pulling gown off arms, invert sleeve cuffs so contaminated outer side remains exposed. Prevent inner side from flipping outward.
6. Ball Up Outward
As it comes off, ball up the gown within itself to keep contaminated exterior surfaces internally oriented.
7. Discard Immediately
Dispose of gown promptly in designated container once removed. Do not hold or allow to contact other surfaces.
8. Remove Any Glove Outer Layer
If double gloved, remove outer glove set using proper technique immediately after gown removal and discard.
9. Redoff New Gown if Needed
For long cases requiring repeat gowning, put on a fresh sterile replacement immediately after fully doffing prior gown.
10. Re-wash Hands
Perform thorough hand hygiene measures after complete gown removal and disposal before any further patient contact.
11. Wipe Down Surfaces
Disinfect any surfaces potentially contacted during the removal process using sterile disinfectant wipes.
12. Turn Away From Field
Face away from any remaining sterile operative sites as you remove gowns to prevent inadvertent contamination.
13. Peel Downward
Draw gown material downward away from shoulders during removal rather than pulling upward over head to avoid disrupting face shields.
14. Check Under Gown
Visually inspect your inner clothing for any moisture or visible contamination after doffing gown.
15. Get Help if Needed
If challenging to remove gown without compromising sterility, request assistance from another scrubbed team member.
Safe sterile gown doffing is vital to avoid preventable breaks in sterility. Incorporate these meticulous steps into your routine gown removal practices.
Disposing of Used Gowns Properly
Safely containing and discarding contaminated surgical gowns after use prevents exposure hazards and infection risks.
This guide outlines crucial evidence-based protocols for proper used gown disposal. Incorporate these steps to halt contamination spread.
1. Designate Gown Disposal Areas
Identify suitable containment areas in the OR for immediate collection of used gowns, such as covered bins or carts.
2. Discard Promptly After Removal
Deposit gown directly into designated waste receptacle immediately after doffing. Avoid setting down in other locations.
3. Double Bag if Heavily Soiled
For gowns with excessive visible contamination, place first in a biohazard waste bag before adding to the general gown disposal.
4. Mind the Exterior Surfaces
Touch only outer surfaces when handling used gowns to get to waste bins. Avoid contact with inner contaminated areas.
5. Invert Sleeves
Invert gown sleeve cuffs during disposal so any inner contaminated surfaces remain internalized within the inverted sleeve.
6. Seal Bags When Full
Frequently seal and replace gown disposal bags as they reach maximum capacity to contain contents.
7. Use Proper Bags
Only use bags compliant with your facility’s medical waste disposal protocols and thick enough to prevent leaks.
8. Wipe Down Receptacles
Disinfect gown disposal bins and carts regularly using appropriate hospital-grade disinfectants.
9. Discard Off-Site Daily
Arrange prompt daily transportation of sealed gown disposal bags to designated off-site regulated medical waste facilities.
10. Post Caution Signs
Clearly label gown disposal areas with biohazard warning signs to prevent inadvertent exposure while awaiting removal.
11. Design Lidded Bins
Select lidded bins or carts with hand-free openings for gown disposal areas. Avoid open-top containers.
12. Separate General Waste Streams
Ensure gown disposal bags remain fully segregated from general facility waste not requiring biohazard disposal.
13. Consider Point-of-Use Options
Install receptacles for immediate disposal directly at individual OR stations to avoid transporting used gowns through suites.
14. Disallow Gown Reuse
Never attempt to save or reuse surgical gowns after doffing even if they appear unsoiled. Discard all used gowns promptly.
15. Contact EVS for Removal
Collaborate with environmental services staff to coordinate routine timely removal of filled gown disposal bags.
Stringent used surgical gown disposal protocols are vital for staff safety and infection control. Incorporate these evidence-based recommendations at your healthcare facility.
Storing Unused Gowns Correctly
Maintaining sterile gown integrity requires proper storage when not in use. Environmental exposure can degrade packaging and compromise sterility.
This guide provides crucial evidence-based protocols for unused gown stock handling and storage. Follow these best practices to uphold gown sterility.
1. Designate Specific Storage Areas
Define dedicated storage spaces such as cabinets or shelving units for unused sterile gowns located away from high-traffic zones.
2. Segregate by Size
Arrange gowns neatly by size within storage areas for easy identification and access to needed sizes.
3. Observe Expiration Dates
Affix and comply with expiration labels on gown packages. Remove any outdated or spoiled gowns promptly.
4. Limit Environmental Exposure
Avoid storing gowns in areas with excessive humidity, moisture, or temperature extremes that could damage packaging.
5. Shelve Properly
Place gowns flat on shelving surfaces rather than stacking or standing packages upright, which can lead to falling and contamination.
6. Watch for Pests
Do not store sterile gowns in risks for vermin exposure. Screen unit vents and immediately address any pest infiltration.
7. Restrict Access
Keep unused gown storage areas locked with access limited only to authorized staff to prevent tampering or compromised inventory.
8. Monitor Stock Daily
Visually inspect gown supplies at least daily to identify any damaged packages in need of prompt removal.
9. Discard if Compromised
Immediately discard any gown packages exhibiting moisture penetration, loose seals, or breaches to packaging integrity.
10. Avoid Sunlight Exposure
Do not store sterile gowns in direct sunlight, such as adjacent to bright windows, which can accelerate material degradation.
11. Control Moisture
Promptly dry any damp storage areas and eliminate sources of moisture like roof leaks or flooding.
12. Maintain Proper Ventilation
Ensure gown storage rooms have adequate air circulation controls to avoid excess microbial buildup.
13. Redo Packaging if Needed
If condensation or minor damage occurs, repackage gowns using sterile technique then promptly reorder pristine replacements.
14. Separate Soiled Items
Ensure used or contaminated items remain fully isolated from unused sterile supplies during processing and transport.
15. Follow Manufacturer Guidelines
Adhere carefully to all specific usage and storage instructions included with gown products.
Diligent sterile protocol compliance and proper environmental controls are essential for maximizing shelf life of sterile unused surgical gowns.
Monitoring Gowns for Integrity and Expiration
Meticulous inspection of sterile surgical gowns is imperative before use. Subtle defects in packaging or expired products can completely undermine sterility.
This guide outlines crucial strategies for verifying gown integrity and freshness. Incorporate these quality checks to confirm flawless aseptic protective properties.
1. Examine Packaging Closely
Scan entire outside of gown packaging carefully for any punctures, tears, gaps, or permeability before opening. Avoid using if compromised.
2. Feel for Moisture
Feel packaging for dampness or wetness which may indicate barrier breach or fluid penetration.
3. Look for Seal Integrity
Ensure adhesive seals joining packaging flaps appear intact without lifting edges or signs of tampering.
4. Verify Expiration
Confirm product expiration date has not passed. Do not use gowns beyond manufacturer expiration timeframes.
5. Smell for Off-Gassing
Smell packaging for chemical off-gassing odors potentially signaling degradation.
6. Assess Fabric Appearance
Once opened, inspect gown fabric visually for discoloration, brittle texture, or strange odors.
7. Check Inner Packaging
For boxes containing multiple individually-wrapped gowns, inspect each internal pouch carefully as above.
8. Notify Manufacturers of Defects
Alert gown suppliers regarding any sterility-compromising damage, expiration, or degradation issues discovered.
9. Isolate Suspicious Products
Remove any questionable gowns from inventory for return/replacement rather than attempting use.
10. Document Assessment Details
Note package condition, expiration, observations, and actions taken related to all inspected gowns.
11. Rewrap if Indicated
For minor isolated package damage, rewrap in sterile drape then promptly replace entire inventory.
12. Do Not Attempt Repair
Never use gowns from packages with sterility-compromising damage or failures.
13. Confirm Sterility if Opened
For pouches opened prematurely, return unexposed gowns for resterilization before attempting use.
14. Rewash Hands After Assessing
Re-sanitize hands thoroughly per protocol after handling gowns and packages to inspect.
15. Inspect Again Just Before Use
Perform another complete sterile gown inspection immediately before donning to confirm suitability.
Consistent due diligence assessing sterile gown integrity minimizes risks of inadvertent contamination and breached sterility.
Complying With Hospital Gowning Policies
Healthcare facilities institute surgical gowning protocols to standardize practices and minimize infection risks. Failing to adhere to institutional policies undermines safety.
This guide outlines key strategies for ensuring total compliance with hospital gowning guidelines. Consistently following these mandates is essential.
1. Review Policies Annually
Reread your hospital’s current gowning policies thoroughly at least once yearly to refresh proper procedures and any recent changes.
2. Attend Required Training
Conscientiously attend all mandatory training activities focused on gowning protocols, technique, and integrity to understand expectations.
3. Ask for Policy Clarification
If any aspect of written gowning policies seems unclear or contradictory, request clarification from infection control leadership.
4. Highlight Key Sections
Notate or flag key sections of gowning policies for quick reference and emphasis of critical steps.
5. Share With Fellow Staff
Discuss policies during pre-op team huddles to identify any areas needing reinforcement.
6. Welcome Audits and Observation
Accept gowning audits and leadership observation positively as opportunities to validate proper adherence.
7. Ask for Feedback
Seek input from peers and mentors regarding their assessment of your gowning practices compared to institutional policies.
8. Role Model Compliance
Set an example for colleagues by visibly and consistently applying policies.
9. Correct Non-Compliance
If observing others not following mandated elements, politely advise them to ensure full policy alignment.
10. Report Deviations
Notify leadership regarding any consistently incorrect or intentional policy deviations needing reeducation.
11. Admit Errors Openly
If realizing you incorrectly followed aspects, honestly acknowledge the lapses to leadership non-punitively.
12. Verify Your Documentation
Ensure any required gowning checklists, forms, and documentation are completed accurately per policy mandates.
13. Suggest Enhancements
Provide feedback to management regarding any potential gowning policy improvements based on your experience.
14. Keep Policies Close By
Maintain gowning protocols conveniently accessible within sterile processing areas for easy reference.
15. Develop Accountability
Accept personal responsibility for meticulous gowning policy compliance rather than cut corners.
Adhering to institutional gowning mandates contributes significantly to positive procedural outcomes. Strive for total alignment through these actions.