The term “donning” refers to the methodical process of putting on protective equipment, specifically gloves, in the context of infection control. This procedure is a fundamental part of personal protective equipment (PPE) protocols in healthcare and science settings. The goal of proper glove donning is twofold: to establish a protective barrier for the wearer’s hands and to prevent the transfer of microorganisms, thereby avoiding cross-contamination. A standardized technique is applied because putting on a glove incorrectly can compromise this barrier.
Context of PPE and Glove Selection
Gloves serve as a physical barrier within the larger system of PPE, designed to minimize exposure to hazards. They are categorized into two main types: non-sterile and sterile. Selecting the correct type is the first step in proper usage.
Non-sterile, or examination, gloves are suitable for routine procedures where the risk of contamination is low, such as general patient care and handling non-sterile items. While manufactured in clean environments, these gloves are not guaranteed to be free of all microbial life.
Sterile, or surgical, gloves undergo rigorous sterilization processes to ensure the complete absence of viable microorganisms. They are required for invasive procedures, such as surgery or inserting a central line, where the risk of infection is significantly higher. Maintaining a contamination-free environment is paramount in these settings. The choice of glove is based on the task’s potential for exposure to blood, body fluids, or non-intact skin, ensuring the level of protection matches the procedure’s risk.
Non-Sterile Gloving Technique
The process for donning non-sterile gloves begins with a non-negotiable step: performing thorough hand hygiene using an alcohol-based rub or soap and water. This is necessary because gloves do not provide complete protection, and the hands underneath must be clean. Hand hygiene prevents the multiplication of bacteria in the moist environment created by the glove. The appropriate size must be selected to ensure a secure fit, as an ill-fitting glove can tear easily or compromise dexterity.
Once hands are clean and dry, the glove is pulled from the box, touching only the cuff. The cuff is the lower edge that covers the wrist. The hand is then inserted into the glove, ensuring the fingers are seated correctly. The glove should cover the wrist and, if a gown is worn, should be pulled over the gown’s cuff to create a continuous barrier.
Sterile Gloving Technique
Sterile gloving, often performed using the “open gloving” method, demands meticulous attention to prevent contaminating the glove’s exterior. After a surgical hand scrub and drying, the sterile glove package is opened on a clean, dry surface, avoiding contact with the inner wrapper. The inner wrapper is unfolded, exposing the gloves, which are arranged with the cuffs folded down.
To don the first glove, the ungloved hand touches only the inside surface of the folded cuff. The hand is slid into the glove, pulling it over the wrist. The cuff remains folded to protect the sterile exterior from the bare skin. The gloved fingers of the first hand are then used to pick up the second glove by sliding them under the cuff’s fold, touching only the sterile outer surface.
The second, ungloved hand is inserted into the glove. The first gloved hand pulls the cuff up over the wrist, being careful not to touch the bare forearm. Once both hands are gloved, the first glove’s folded cuff can be unfolded by sliding the now-gloved fingers underneath the sterile fold, completing the aseptic barrier. Hands must be kept above waist level and away from the body throughout this process to maintain the sterile field.
Safe Removal (Doffing) and Disposal
The process of removing gloves, known as doffing, is important as it prevents contamination of the hands and environment. The accepted technique follows the principle of “glove-to-glove, skin-to-skin” to ensure the contaminated exterior never touches the bare skin. The wearer grasps the outside of one glove near the wrist with the opposite gloved hand.
The first glove is peeled off, turning it inside out, and is held in the palm of the remaining gloved hand. The wearer slides the fingers of the now-bare hand underneath the cuff of the second glove, touching only the clean, interior surface. This second glove is then peeled off, turning inside out and trapping the first contaminated glove inside, creating a compact bundle of waste. The gloves are immediately discarded into the appropriate waste receptacle, such as a biohazard container if soiled with infectious material. The final step is to perform hand hygiene immediately after disposal to eliminate any residual contamination.