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Checkilist Gowning

This document is a performance checklist for gowning in the nursing program, detailing the steps and grading criteria for the procedure. It includes a scoring system ranging from Excellent to Not Performed, assessing various aspects of the task such as accuracy, systematic performance, and confidence. The checklist also provides space for comments and signatures from the clinical instructor and student.

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Justine Nicole F. Jerusalem
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9 views1 page

Checkilist Gowning

This document is a performance checklist for gowning in the nursing program, detailing the steps and grading criteria for the procedure. It includes a scoring system ranging from Excellent to Not Performed, assessing various aspects of the task such as accuracy, systematic performance, and confidence. The checklist also provides space for comments and signatures from the clinical instructor and student.

Uploaded by

Justine Nicole F. Jerusalem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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COLLEGE OF NURSING, NUTRITION AND DIETETICS

NURSING PROGRAM

NAME: _________________________________ SECTION: __________________ SCORE: _________________

GOWNING

PERFORMANCE CHECKLIST

GRADING CRITERIA: LEGEND:


Performance Of Task:
1. Performs task correctly & accurately 5 - Excellent (E) 2 - Needs Improvement (NI)
2. Performs task systematically 4 - Very Satisfactory (VS) 1 - Incorrectly Performed (IP)
3. Finishes procedure on time. 3 - Satisfactory (S) 0 - Not Performed (NP)
4. Performs task with ease & confidence.
5. States correct rationales/terms. Time allotment: ________

E VS S NI IP NP
Meets Meets Meets Meets Meets Not
Procedure for GOWNING all all all all all Per-
criteria criteria criteria criteria criteria formed
5 4 3 2 1 0
1. Surgically scrub hands, then dry it.
2. Grasp gown firmly.
3. Lift gown directly away from the sterile field.
4. Step back from the table and extend arm at level
of upper chest.
5. While keeping arm extended and elbows slightly
flexed locate the edge of the gown's neck.
6. Hold the gown securely and unfold it gently by
shaking, keeping in mind that armholes should
face the wearer. Then slip the hands into
armholes.
7. The circulating nurse places each hand in the
inner seam and pulls the gown over the wearers
shoulders and then ties the back straps.
8. To tie the belt of the gown:
1.1 Scrub nurse forwards and swings the end of
the belt.
1.2 The circulating nurse grasps the end of the belt
and ties them at the back.
COMMENTS: Total Grade:

CI’s Signature: Student’s Signature:

_________________________________ ____________________________________

120 YEARS OF AUGUSTINIAN EXCELLENCE IN VIRTUS ET SCIENTIA


Contact No.: 0939-278-9080
Email: [email protected] | Website: www.usa.edu.ph

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