Nursing Clinical Practice Guide
Clinical Scenario: You are in a medical-surgical unit changing the dressing on a patient's abdominal incision from a recent colectomy. Your sterile field is set up on the bedside table. As you reach for a 4x4 gauze, the cuff of your sterile glove touches the plastic outer wrapper of the gauze package, which is lying just outside the sterile field.
Nursing Intervention Strategy:- 1Assessment & StopImmediately recognize the break in technique. Verbally acknowledge it to any assisting staff ("I've contaminated my glove").
- 2Safe RemovalCarefully remove the contaminated glove by grasping the cuff and pulling it inside out, holding it in the still-gloved hand. Then, remove the remaining sterile glove by sliding fingers inside the cuff. This contains the contamination.
- 3Hand HygienePerform hand hygiene (hand rub or wash) according to protocol.
- 4Re-establish SterilityOpen a new pair of sterile gloves using proper technique. Also, consider the gauze package that was touched. Since the outer wrapper was touched with a contaminated glove, it is safer to discard that entire package and open a new one to ensure no cross-contamination occurred when opening it.
- 5Proceed & EvaluateComplete the dressing change. Afterward, evaluate the wound in subsequent shifts for any signs of infection (redness, swelling, purulent drainage).
Patient Safety and Precautions:
• Never attempt to "clean" a contaminated glove or item with alcohol or antiseptic. This is not effective for restoring sterility.
• The one-inch border around a sterile drape is considered non-sterile. If an ungloved hand or a contaminated object touches this border, the entire drape is not necessarily contaminated—only the item that touched it is. However, if a sterile-gloved hand touches the border, that glove is now contaminated.
• Always prepare your sterile field in a clean, dry, waist-level area away from traffic to minimize accidental contamination.
Nursing Procedure & Medication Flow
Sterile Gloving Procedure (Open Method) After Contamination:
1. After hand hygiene, open the sterile glove package on a clean, dry surface.
2. With your non-dominant hand, pick up the first glove by its folded cuff (the inside, which will touch your skin, is not sterile).
3. Guide your dominant hand into the glove, pulling the cuff up without touching the outside of the glove.
4. Slide your gloved fingers under the cuff of the second glove to pick it up without touching its outside.
5. Guide your non-dominant hand into the glove, pulling it on securely.
6. Adjust fingers, interlocking if necessary, without touching non-sterile surfaces.
A Word from Your Senior Nurse
"In the fast-paced clinical environment, it's easy to feel pressured to 'just get the task done,' especially when you're busy. But remember this: taking the extra 60 seconds to change your gloves and get new supplies isn't a delay—it's the essence of safe, quality nursing care. Protecting your patient from a preventable infection is one of your most critical roles. On the NCLEX, they are testing your commitment to these fundamental safety principles. In practice, that commitment builds trust with your patients and your team. Always err on the side of caution with sterility!"