Donning and Removing Non sterile gloves (Checklist)
Name:
Date:
Procedure
1.Knock on door, ask permission to enter
2.Identify self and patient/client/resident
3.Explain procedure you are about to perform
4.Wash hands and dry thoroughly.
5. Remove gloves from box, one at a time.
6.Place hand through opening and pull the
glove on to the wrist
7.Repeat with second glove
8. Adjust gloves to cover wrists or cuffs of
gown.
9.Complete client care.
To Remove Gloves
1.Grasp one glove on the inside of wrist at ½
inch below band of glove without touching
the skin.
2. Pull down glove, turning it inside out, and
hold the glove with the still-gloved hand.
3. Insert fingers of ungloved hand under the
cuff of the glove on the other hand (on inside
of cuff).
4.Pull down glove until it is inside out,
drawing it over the first glove
5. Discard both gloves into wastebasket.
6. Wash hands
yes no Team Leader Instructor
Pass_____Repeat________