How to do open gloving?

Open gloving is a fundamental technique used in healthcare settings to don sterile gloves while maintaining sterility, particularly when a sterile gown is not required or when only gloves are needed for a procedure. It involves carefully handling the gloves to prevent contamination of the outer, sterile surfaces.

Understanding Open Gloving

Open gloving is a method for applying sterile gloves without the assistance of a sterile gown or another sterile person. This technique requires meticulous attention to avoid touching the outer sterile surface of the gloves with bare hands. It's typically used for procedures that require sterile hands but not necessarily a full sterile field, such as inserting a urinary catheter, performing a sterile dressing change, or certain minor surgical procedures.

Key Principles of Sterility

• Sterile-to-Sterile: Only sterile items may touch other sterile items.
• Sterile-to-Unsterile Contamination: If a sterile item touches an unsterile item, it is considered contaminated.
• Edge of Sterility: The edges of a sterile field or package are considered unsterile.
• Working Above the Waist: Keep sterile items above waist level to avoid accidental contamination.

Step-by-Step Guide to Open Gloving

Before beginning, ensure you have the correct size of sterile gloves and a clean, flat surface.

1. Preparation

• Hand Hygiene: Begin by performing meticulous hand hygiene. Wash your hands thoroughly with soap and water or use an alcohol-based hand rub according to facility guidelines. Allow hands to dry completely.
• Inspect Packaging: Check the sterile glove package for tears, punctures, or signs of moisture. Ensure the expiration date has not passed. Discard if any compromise is noted.
• Open Outer Wrapper: Place the sterile glove package on a clean, dry, flat surface at waist level. Carefully open the outer wrapper without touching the inner sterile package, peeling it open from the top down or as indicated by the package design.

2. Donning the First Glove (Dominant Hand)

The cuffs of the gloves are typically turned inside out within the sterile packaging, making it easy to grasp the inside surface without contaminating the sterile exterior. You should always put the glove for your dominant hand on first. For right-handed individuals, this means the right glove is donned first.

1. Grasp the Inner Cuff: With your non-dominant hand, pinch or grasp the inside surface of the cuff of the glove for your dominant hand. Be careful to touch only the surface that will be in contact with your skin.
2. Lift and Insert: Lift the glove straight up, away from the package, ensuring it doesn't touch any unsterile surfaces. Slide your dominant hand into the glove, aligning your fingers with the glove fingers.
3. Partially Don: Pull the glove on fully, but leave the cuff folded back for now. Do not adjust the cuff with your bare non-dominant hand.

3. Donning the Second Glove (Non-Dominant Hand)

1. Grasp the Outer Cuff: With your gloved dominant hand, slide your gloved fingers underneath the cuff of the second glove (for your non-dominant hand). Ensure you touch only the sterile outer surface of this glove.
2. Lift and Insert: Lift the second glove straight up, away from the package. Slide your non-dominant hand into the glove, carefully aligning your fingers.
3. Fully Don: Pull the second glove on completely.

4. Adjusting the Gloves

Once both hands are gloved, you can adjust them to ensure a comfortable and secure fit.

1. Adjust First Glove: Using your now gloved non-dominant hand, slide your fingers underneath the sterile cuff of your dominant hand's glove and pull it up over your wrist or the cuff of your gown if you are wearing one. Remember to touch only sterile-to-sterile surfaces.
2. Adjust Second Glove: Similarly, use your gloved dominant hand to adjust the cuff of your non-dominant hand's glove, pulling it up over your wrist or gown cuff.
3. Finger Alignment: Adjust fingers and palm areas for comfort and dexterity.

5. Post-Gloving

• Maintain Sterility: Keep your gloved hands above waist level and away from your body. Avoid touching any unsterile surfaces.
• Proceed with Procedure: You are now ready to begin the sterile procedure.
• Removal: When the procedure is complete, remove gloves using a "glove-to-glove" and "skin-to-skin" technique to avoid contamination. Dispose of them appropriately and perform hand hygiene immediately.

Tips for Success

• Patience is Key: Take your time. Rushing increases the risk of contamination.
• Practice: Like any skill, gloving improves with practice.
• Check for Tears: Always inspect your gloves for tears or holes, especially after donning them. If a tear occurs, remove the contaminated gloves and don a new sterile pair.
• Awareness: Be mindful of your surroundings and avoid unnecessary movements that could lead to contamination.

For further guidance on sterile techniques, refer to reputable sources such as the Centers for Disease Control and Prevention (CDC) or the Association of PeriOperative Registered Nurses (AORN).