Maximal Barrier Precautions
(continued)

Sterile Gown: The gown is presented in a way that allows you, the clinician, to slip your hands through the armholes without touching the sterile side of the gown. As you move your arms in an outward motion, the gown unfolds covering your arms and shoulders; an assistant then grasps the strings and ties the gown behind your neck. Care should be used as you pass your hands through the sleeves. You should not allow your hands to extend beyond the cuffs of the sleeves as your hands are never considered sterile. Keep cuffs of gown well over hands. Once gown is on and tied, it is time to don the sterile gloves.

Sterile Gloves: According to the CDC, sterile gloves are to be worn for the insertion of all central venous catheters (9). Donning sterile gloves requires a specific technique. The gloves are folded and cuffed exposing the inner glove so that the outer glove is not touched by the hand. Grasp the cuff of one glove with the fingertips of the opposite hand which is still covered by the sterile gown sleeve. This way, only the sterile gown touches the sterile glove. Slip hand into glove and pull the cuff over to unroll glove and cover hand and sleeve cuff. Using the gloved hand, open the second glove from underneath the cuff allowing the sterile glove to touch the sterile portion of the second glove; slide second hand into glove and unfold to cover hand and sleeve cuff. Always overlap gown and glove cuffs. It is essential to avoid touching non-sterile items once sterile gloves are applied; the hands and fingers may be kept interlaced and in front of you at or above waist level to avoid inadvertent contamination. Refrain from adjustment of the mask or scratching of the nose once sterile gloves are in place. Any break in the glove or touching the glove to a non-sterile surface requires immediate removal with gown cuffs pulled down and the application of new gloves.