Donning Sterile Gloves: What Observers Must Watch For

Are We Even Ready?

Quick checks before the gloves come out:

• Hands and nails: Short, natural nails with no polish or gel, no jewelry, intact skin.
• Garbing order: The location of the sink drives facility procedures. Know the garbing order and if it looks out of sequence, pause and reset.
• Hand hygiene: Use of a nail pick and a full 30 second wash to the elbows. Hands and forearms are completely dried.

Observer tip: If hands and forearms are still damp, gloving cannot begin.

Opening the Package

What to watch:

• Removal from outer package: Remove the gloves from the outer package before applying the alcohol-based hand rub.
• Edges vs. insides: Only the outside edges of the inner glove wrapper are touched. No touching the inside of the wrapper.
• Orientation check: Thumbs line up correctly before the first glove is touched. (Left glove picked up for the left hand, etc.)

Observer tip: If any glove surface except the cuff is touched by a bare hand, the gloves are contaminated and they need to grab another pair.

The First Glove

With a clean, dry hand, pick up the first glove by the folded cuff, avoiding the external glove surface. Keeping fingers close together, slide the hand into the glove without fully opening the hand.

Observer focus points:

• Contamination risk: Ensure the glove is fully picked up from the wrapper so that it does not touch anything.
• Cuff is critical: The cuff must stay in place. Once the cuff is lost on the first glove, the gloves cannot be properly donned.
• Fit matters: A glove that’s too small rips; too big flops and grazes non-sterile items.

Observer tip: Focus on the cuff. If staff struggle to maintain the cuff, it might be time for more focused training on proper sterile gloving technique.

The Second Glove

Now the gloved hand is your “sterile tool.” Work all four gloved fingers under the folded cuff and pick up the second glove. Don the second glove, pulling the cuff up and over the gown sleeve.

Watch for:

• Sterile-on-sterile contact: Only the gloved hand touches the outside of the second glove.
• Pinching the cuff: This is dangerous practice with a high risk of contamination. Instead, ensure staff use the cuff as a protective barrier for the gloved fingers.
• No gown or skin contact: Gloved fingers must not touch the gown or the hand. Keeping the thumb of the already gloved hand up and out helps.

Observer tip: The second glove must be picked up from the wrapper. This allows for easier donning and reduces the risk of contamination.

Back to the First Glove

Work all four gloved fingers of the second gloved hand under the folded cuff of the first glove, keeping the thumb up and out. Pull the glove cuff up and over the gown sleeve.

Watch for:

• Glove protection: All four gloved fingers must go under the cuff, not just one!
• No gown or skin contact: Gloved fingers must not touch the gown or the hand. Keeping the thumb of the already gloved hand up and out helps.

Observer tip: Watch closely! An experienced individual may don gloves quickly and if you’re not paying close attention, you could miss a mistake in technique.

After Both Gloves Are On

Final refinements observers should check:

• Cuff coverage: Glove cuffs overlap gown without exposed skin.
• No tears: Inspect for micro-tears or snagged tips.
• Behavioral sterility: Hands must not touch anything if gloved fingertip testing to be performed.

Observer tip: If administering gloved fingertip testing after garbing, remind staff not to touch anything once gloves are donned. If they do, they must glove again!

Contamination Moments

Even tenured staff make mistakes. What matters is the recovery. As an observer it is critical that you catch the mistake, call it out, and work with the individual to correct it.

High-likelihood mistakes & fixes:

• Damp hands before donning: Remove gloves, dry fully hands, and start the gloving procedure over.
• Touching a non-sterile surface: Immediately change the contaminated glove (or both, if unsure).
• Losing the cuff on the first glove: Remind staff to keep their fingers closer together and to work the glove of the wide part of the hand instead of pulling the glove straight down. If the cuff is lost, they are starting again.

Observer language that helps:

• “Let’s pause here. What just contacted your glove?”
• “What’s your recovery step?” (Let the staff member say it and do it.)

Wrap-Up: Share the Why, Not Just the What

End with two questions:

1. “Where was your highest contamination risk?”
2. “What adjustment will you try next time?”

Observers who connect actions to risk prevention build confidence and safer habits. Turn sterile gloving from a routine into a reliable performance—every time, with Parasol’s line of gloved fingertip testing products!