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Setting up a sterile field and putting on sterile gloves

  • Procedure

How to open sterile supplies, set up a field and put on sterile gloves without contaminating them.

Updated

What it is

The sterile field is the work area that holds only sterile supplies and from which an invasive procedure is carried out. It is set up on a clean, dry surface at waist height or above, with intact, in-date packages. Sterile gloves are put on with the open technique: skin touches only the inside of the glove and the glove touches only sterile items. If anything is contaminated, it is replaced.

Indications

  • Insertion of an indwelling urinary catheter.
  • Central line care and dressing changes.
  • Any procedure that punctures or incises the skin or enters a body cavity.
  • Any procedure the institutional protocol defines as sterile.

Contraindications and precautions

  • Do not use wet, torn or expired packages.
  • Disinfect the work surface and let it dry fully; it stays at waist height.
  • Do not turn your back on the field or reach over it.
  • If the patient or clinician has a latex allergy, use latex-free sterile gloves.
  • Keep your body, clothing and loose objects away from the field; nothing hangs over it.

Equipment

  • Sterile pack or kit with a drape.
  • Sterile gloves of the correct size.
  • Sealed, in-date sterile solutions.
  • Sterile bowl or tray.
  • Clean, dry over-bed table.
  • Alcohol-based hand rub or a sink.

Step by step (and why)

  1. Explain the procedure to the patient and perform hand hygiene — it gains their cooperation and reduces microorganisms.
  2. Disinfect the work table and let it dry, at waist height — moisture and anything below the waist contaminate.
  3. Check expiry, the indicator colour and integrity of every package — a torn, damp or expired package is not sterile.
  4. Place the pack on the table and open the far flap first, touching only its outer edge — you never reach over the open field.
  5. Open the side flaps one at a time and the near flap last, keeping arms away from the field — the inside stays sterile.
  6. Drop sterile items from about 15 cm, inside the field and away from the 2.5 cm border — the border is considered non-sterile.
  7. Pour solutions from the side, about 15 cm up, slowly, into the sterile bowl — it avoids splashing and wetting the field.
  8. With the non-dominant hand, take the dominant-hand glove by the inside of the cuff and pull it on — skin touches only the inside.
  9. Slide gloved fingers under the second cuff, thumb held out; tuck the bare thumb in and pull the glove on — sterile touches only sterile.
  10. Keep hands above the waist and in view; if anything is contaminated, replace it — carrying on with contaminated supplies exposes the patient.

Complications

  • Unnoticed contamination of the field, with a risk of infection at the procedure site.
  • Catheter-associated urinary tract infection or catheter-related bloodstream infection if technique breaks.
  • Allergic reaction to latex gloves.
  • Splashes while pouring that wet the field and let microorganisms wick through.

Next step: when to call for help

  • If you contaminate the field or the gloves, say so out loud, stop and replace the supplies.
  • If no spare sterile supplies are available, tell the nurse in charge before going on.
  • If the patient moves and touches the field, stop, explain again and set up the field again.
  • Record any break in technique according to the institution's protocol.

Test yourself

Think of the answer, then tap the question to see it.

Which hand picks up the first sterile glove, and where?

The non-dominant hand picks up the glove for the dominant hand, only by the folded inner cuff, so the skin touches only the inside.

From where is a sterile solution poured onto the field?

From the side of the field, about 15 cm up, slowly and into a sterile container, so the field is not splashed or wetted.

What happens if the clinician turns their back on the sterile field?

The field is considered contaminated, because it was out of sight, and must be set up again.

What is done to the work surface before placing sterile supplies on it?

It is disinfected and left to dry completely, because moisture lets microorganisms pass through the sterile drape.

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Connections

← All of nursing

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Guideline for Prevention of Catheter-Associated Urinary Tract Infections (2009): Summary of Recommendations (Centers for Disease Control and Prevention (CDC), 2009); Nursing Skills, 4.4 Sterile Fields (Open RN, Wisconsin Technical College System (LibreTexts copy, CC BY 4.0), 2021); Nursing Skills, 4.8 Checklist for Applying and Removing Sterile Gloves (Open RN, Wisconsin Technical College System (LibreTexts copy, CC BY 4.0), 2021); Latex Allergy: A Prevention Guide (Publication 98-113) (CDC / National Institute for Occupational Safety and Health (NIOSH), 1998).

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Representative model, for educational purposes only.