Nursing care
Sterile gloving and the sterile field: open-glove technique, boundaries and fixing a break
Written and reviewed by Dana Whitfield, RN, MSN · 4 min read · Updated October 2026
Short answer
In open gloving, the bare hand touches only the folded inner cuff of the first glove, and the gloved hand touches only the outside of the second. On a sterile field, the outer inch, anything below waist level and anything out of sight is contaminated. When sterility is broken, stop, discard the contaminated item or gloves and start again.
When a sterile field is needed
Surgical asepsis aims to keep a defined area free of all microorganisms. A sterile field is established when skin is deliberately punctured or incised, when a procedure enters a body cavity, or when contact with non-intact skin is likely. Examples include urinary catheter insertion, some wound care and assisting with central line insertion.
Only sterile items belong on the field. Before opening any package, check for damage, moisture, holes, tears, an expiry date and the sterilisation indicator. A package that fails any check is not used. Disinfect and dry the work surface first, and place it at or above waist level where you can see it throughout.
Open-glove technique step by step
Perform hand hygiene and open the glove package on a clean, dry surface at waist level, unfolding the inner wrapper without touching its inside. With the non-dominant hand, grasp only the folded inner cuff of the dominant glove, lift it clear and pull it on. The bare hand never touches the outer surface.
With the gloved hand, slide four fingers under the cuff of the second glove, keeping the thumb out of the way, and pull it onto the other hand. The sterile glove touches only sterile surfaces. Adjust the fit once both are on and keep hands above the waist and in view. Donning gloves away from the field avoids contaminating it. To remove gloves, peel the first off inside out using the other gloved hand, then slip a bare finger inside the second cuff and peel it over the first before performing hand hygiene.
Field boundaries: what counts as contaminated
Treat these areas as contaminated: the outer inch of the drape or wrapper, any part hanging below the table surface, anything below waist level or above shoulder level, anything you have turned away from or left unattended, and the area around holes, tears or moisture wicked from an unsterile surface. Moisture carries organisms through barriers by wicking.
Open kits away from your body first, then the sides, then the flap nearest you, without reaching across the field. Drop items onto the field from a short distance and pour solutions from the side, not over the field. Treat an opened bottle according to policy, usually as single use, rather than recapping it and pouring onto the field again later.
Recognising and correcting a break in sterility
Common breaks include touching the outside of a glove with a bare hand, letting a gloved hand drop below the waist, brushing the field with a sleeve, splashing fluid onto it, turning your back on the field or dropping an item onto the edge. If you are unsure whether something was contaminated, treat it as contaminated.
Stop and say so, even if no one else noticed. Replace contaminated gloves, remove a contaminated item, or set up a new field if the field itself is compromised. If contamination occurred during a procedure, follow local policy for reporting. Admitting a break protects the patient; continuing to save time or supplies does not. Planning ahead, with all supplies opened before gloving and a second person available, prevents many breaks.
Apply the principles to a study scenario
In a hypothetical item, a nurse inserting a urinary catheter notices the gloved dominant hand brushed the outer edge of the sterile drape. Options include continuing because the drape is sterile, wiping the glove with antiseptic, or stopping to replace the glove before continuing. Replacing the glove is correct because the outer inch counts as contaminated.
A variation describes a sterile item that rolled onto the outer border of the field. The item should be removed rather than moved back to the centre. Document the procedure as usual, and report any break that reached the patient, such as a contaminated catheter inserted, according to your facility's process.
Sources and further reading
Open RN Nursing Skills (via LibreTexts): 4.4 Sterile Fields. When a sterile field is needed, package checks, contaminated areas of the field, opening kits and pouring solutions.
Open RN Nursing Skills (via LibreTexts): 4.8 Checklist for applying and removing sterile gloves. Step-by-step open-glove technique and glove removal.
The next step on this is the same as on everything else here: answer questions and read the rationales. Our fundamentals practice questions are the closest set to what this page covers.
Common questions
Which part of a sterile field is considered contaminated?
The outer inch, anything below the table edge or waist level, anything above shoulder level, areas that are wet or torn, and anything not kept in view.
What may the bare hand touch during open gloving?
Only the folded inner cuff of the first glove. After that, the gloved hand touches only the outside of the second glove under its cuff.
What should a nurse do after an unnoticed break in sterility?
Stop, acknowledge it and replace the contaminated gloves, item or field. Report it if the contamination reached the patient. Uncertain sterility is treated as contaminated.
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