Ateneo de Zamboanga University

College of Nursing
NURSING CARE MANAGEMENT 112j RLE (SKILLS LABORATORY)
OPERATING ROOM TECHNIQUES

NAME: ________________________________ DATE: __________________

YEAR & SECTION: _____________

SURGICAL SCRUBBING

TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS

1. Don the cap and mask. Remove wrist watch
and rings. Make sure that the sleeves are
above the elbows
2. Ensure that scrub suit is tucked at the waist.
Prepare surgical brush
3. Wet the hands and forearms under running
water, holding the hands above the level of
the elbows so that the water runs from the
fingertips to the elbows
4. Apply 2 to 4 mL (1tsp) soap/aseptic solution
to the hands
5. Start scrubbing on one hand. Using firm,
rubbing, and circular motion for 2-5
minutes to wash in between fingers, palm,
back of the palm, wrist, arm and up to the
elbow.
6. Rinse the brush and hand from the
fingertips up to the elbow
7. Check the nails and clean them with a file
or orange stick if necessary. Rinse the nail
tool after each nail is cleaned.
8. Do the same procedure on the other hand
9. After both hands are scrubbed, remained,
hands in upright position and allow extra
water to drip for a second
10. Then with your back enter the OR theater
by pushing the door for you to enter the
room.
TOTAL SCORE:

_________________________
Clinical Instructor
Title: Operating Room Scrubbing Procedures Rubric
RUBRIC DESCRIPTOR
1 - Poor Inadequate scrubbing technique with multiple missed areas and
improper hand positioning
2 - Below Average Some areas missed or insufficient scrubbing duration, with minor issues
in hand placement.
3 - Satisfactory Adequate scrubbing technique with minor areas missed or occasional
deviations in hand positioning.
4 - Good Consistent and thorough scrubbing technique with only minor areas
missed, and proper hand placement.
5 - Excellent Flawless scrubbing technique, covering all areas thoroughly, and
maintaining proper hand positioning throughout.

Ateneo de Zamboanga University

College of Nursing

NURSING CARE MANAGEMENT 112j: RLE (SKILLS LABORATORY)

OPERATING ROOM TECHNIQUES
NAME: __________________________________________ DATE: __________________
YEAR & SECTION: _____________

DONNING OF STERILE GLOVES

(OPEN GLOVE TECHNIQUE)
TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS
1. Pick up 1 pack of powder, open and
pour it into your hands
2. Spread it evenly into your hands and
fingers, do not clap hands after
spreading
3. Open the glove wrapper with gloves
of your own size
4. With your left hand grasp the cuff of
the right hand glove on the fold. Pick
it up and step backward
5. Insert the right hand into the glove
with palm up and pull it on leaving
the cuff turned well down over the
hand
6. With your gloved hand, slip the
fingers under the everted cuff of the
left glove. Pick up and step backward
7. Fix gloves on both hands and fingers.
With one hand anchor the folded cuff
of the glove to your left thumb
8. Make a pleat of the stockinette of the
left thumb with fingers of your right
hand and then pull the glove over the
cuff of your sleeve. Avoid touching
the bare wrist.
9. Release the anchored glove from
your left thumb with fingers of your
right hand and then pull the glove
over the cuff of your sleeve. Avoid
touching the bare wrist.
10. Repeat the procedure from nos. 7 – 9
using the opposite hand.
TOTAL SCORE:

___________________
Clinical Instructor

Title: Operating Room Open Gloving Procedures Rubric

RUBRIC DESCRIPTOR
1 - Poor Struggles significantly with glove placement, requiring assistance,
and making multiple attempts.
2 - Below Average Occasionally experiences difficulty with glove placement, leading to
minor delays in the procedure.
3 - Satisfactory Usually places gloves properly but may encounter some minor
challenges during the process
4 - Good Competently places gloves with ease and minimal delays,
maintaining sterility effectively.
5 - Excellent Expertly and swiftly places gloves with precision, ensuring a sterile
environment is consistently maintained

Ateneo de Zamboanga University

College of Nursing
NURSING CARE MANAGEMENT 112j: RLE
OPERATING ROOM TECHNIQUES
NAME: __________________________________________ DATE: __________________
YEAR & SECTION: _____________
 DONNING OF STERILE GLOVES
(CLOSED GLOVING TECHNIQUE)
TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS
1. Open the sterile pack of gloves and drop
them into the sterile field
2. Left hand (within the gown) lift the right
glove by its cuff
3. Right glove is laid on the palm of the right
hand (cuff to cuff with the gown sleeve)
with fingers of the glove pointing toward
the elbow and the thumb of the glove
positioned on the top of the covered right
thumb
4. The inside of the cuff of the glove is grasped
by the right hand (still within the gown) and
the left hand folds the hand of the glove
over the back of the right hand.
5. The left hand then pulls the cuff of the right
glove and sleeve of the right gown towards
the elbow as the right hand slides into the
glove
6. Wait to adjust the glove until both gloves
are on the end sterility is ensured (left
fingers may slip out of the gown while
trying to adjust the right glove prematurely)
7. With the gloved right hand lift left gloved by
its cuff and place on palm of left hand
(aligned with the cuff of the gown), with
glove fingers pointing toward the elbow and
the left thumb of the glove over the
covered left thumb of the nurse.
8. Left fingers (still within the gown) grasp the
inside of the glove and the right hand pulls
left glove cuff over the back of the hand
9. Pull the glove cuff and gown sleeve toward
elbow as lefthand slides into the glove
10. Now that both gloves are on, pull glove
cuffs over gown’s sleeves and adjust gloves
for comfort
TOTAL SCORE:

________________
Clinical Instructor

Title: Operating Room Closed Gloving Procedures Rubric

RUBRIC DESCRIPTOR
1 - Poor Struggles significantly with glove placement, requiring assistance,
and making multiple attempts.
2 - Below Average Occasionally experiences difficulty with glove placement, leading to
minor delays in the procedure.
3 - Satisfactory Usually places gloves properly but may encounter some minor
 challenges during the process
4 - Good Competently places gloves with ease and minimal delays,
maintaining sterility effectively.
5 - Excellent Expertly and swiftly places gloves with precision, ensuring a sterile
environment is consistently maintained.

Ateneo de Zamboanga University

College of Nursing

NURSING CARE MANAGEMENT 112j: RLE

OPERATING ROOM TECHNIQUES
DONNING OF STERILE GOWN
NAME: __________________________________________ DATE: __________________
YEAR & SECTION: _____________

DONNING OF STERILE GOWN

TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS

1. Open the sterile pack of gloves and drop them into
the sterile field
2. Left hand (within the gown) lift the right glove by
its cuff
3. Right glove is laid on the palm of the right hand
(cuff to cuff with the gown sleeve) with fingers of
the glove pointing toward the elbow and the
thumb of the glove positioned on the top of the
covered right thumb
4. The inside of the cuff of the glove is grasped by
the right hand (still within the gown) and the left
hand folds the hand of the glove over the back of
the right hand.
5. The left hand then pulls the cuff of the right glove
and sleeve of the right gown towards the elbow as
the right hand slides into the glove
6. Wait to adjust the glove until both gloves are on
the end sterility is ensured (left fingers may slip
out of the gown while trying to adjust the right
glove prematurely)
7. With the gloved right hand lift left gloved by its
cuff and place on palm of left hand (aligned with
the cuff of the gown), with glove fingers pointing
toward the elbow and the left thumb of the glove
over the covered left thumb of the nurse.
8. Left fingers (still within the gown) grasp the
inside of the glove and the right hand pulls left
glove cuff over the back of the hand
9. Pull the glove cuff and gown sleeve toward elbow
as left hand slides into the glove
10. Now that both gloves are on, pull glove cuffs over
gown’s sleeves and adjust gloves for comfort
TOTAL SCORE:

_________
_________________
Clinical Instructor
Sign over printed name

Title: Donning of Sterile Gown Procedures Rubric

RUBRIC DESCRIPTOR
1 - Poor Frequent contamination of the gown or gloves, resulting in breaks
in sterile technique.
2 - Below Average Occasional contamination of the gown or gloves, leading to some
concerns about sterile technique.
3 - Satisfactory Minimal contamination of the gown or gloves, mostly maintaining
sterile technique.
4 - Good Infrequent or minor contamination of the gown or gloves,
consistently maintaining sterile technique.
5 - Excellent No contamination of the gown or gloves observed, demonstrating
impeccable sterile technique throughout.

Ateneo de Zamboanga University

College of Nursing

NURSING CARE MANAGEMENT 112j: RLE

OPERATING ROOM TECHNIQUES
GOWNING ANOTHER PERSON
NAME: __________________________________________ DATE: __________________
YEAR & SECTION: _____________

GOWNING ANOTHER PERSON

TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS

1. Open the hand towel and lay it on the
surgeon’s hand, taking care not to touch
the hand.
2. Unfold the gown carefully, holding it at
the neck band.
3. Keeping hands on the outside of the gown
and using the neck and shoulder areas of
the gown as protective cuffs over the
gloves, offer the inside surface of the
gown to the surgeon. He/She then slips
his/her arms into the sleeves.
4. Release the gown. The surgeon holds
his/her arms outstretched while the
circulating nurse pulls the gown onto the
shoulders and adjust the sleeves so that
the cuffs are properly placed. In doing so,
only the inside of the gown is touched at
the seams.

GLOVING ANOTHER PERSON

TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS

1. Pick up the right glove and grasp it firmly
with the fingers under the averted cuff.
Hold the palm of the glove toward the
surgeon.
2. Stretched the cuff sufficiently for the
surgeon to introduce his/her hand. Avoid
touching the surgeon’s hand by holding
your thumbs out or abducting them.
3. Exert upward pressure as the surgeon
plunges his/her hand into the glove.
4. Unfold the everted glove cuff over the
cuff of the sleeve.
5. Repeat the previous steps for the left
hand.

__________________________
Clinical Instructor
Sign over printed name

Ateneo de Zamboanga University

College of Nursing

NURSING CARE MANAGEMENT 112j: RLE

OPERATING ROOM TECHNIQUES

REMOVING THE GOWN AND GLOVES

 TERMINAL COMPETENCIES 1 2 3 4 5 REMARKS
REMOVAL OF THE GOWN (The gown is
removed
before the gloves)
1. With gloves on, grasp the front shoulder of the
gown and pull it forward.
2. When pulling the gown off the arms, make sure
that the gown sleeve is turned inside-out to
prevent contamination of the scrub attire.
3. The other shoulder is grasped with the other
hand, and the gown is removed entirely by
pulling it off inside-out and rolling it away
from the body.
REMOVAL OF GLOVES (The glove to glove
technique and then the skin to skin technique)
4. Grasp the cuff of the left glove with the gloved
fingers of the right hand and pull it off inside
out.
5. Slip the ungloved fingers of the left hand under
the cuff of the right glove and slip it off inside-
out.
6. Discard the gloves in trash receptacle.
TOTAL SCORE:

__________________________
Clinical Instructor
Sign over Printed name