Guidelines in Practice: Surgical Attire

Abstract

Surgical attire provides a barrier to microorganisms shed from health care workers’ skin and hair to help protect patients and promote a clean environment. The AORN “Guideline for surgical attire” includes recommendations for selecting, wearing, and cleaning surgical attire that are based on the highest‐quality evidence available. Recommendations are rated as Regulatory Requirement, Recommendation, Conditional Recommendation, or No Recommendation according to the level of evidence, an assessment of the benefits versus harms of implementing specific interventions, and consideration of resources required to implement the interventions. This article discusses guideline recommendations related to laundering surgical attire, wearing long‐sleeved attire, and wearing head coverings. A scenario provides an example in which an interdisciplinary facility team uses a gap analysis and a risk assessment to prioritize process changes for implementing the guideline. Perioperative personnel should review the entire guideline for additional information and for guidance when creating and updating policies and procedures.

Nurses’ knowledge regarding recommended practices on using surgical attire in operating theatre

“…Hence, it is advisable to put this educational intervention into practice within operating theatres. However, when implementing the educational intervention, the latest AORN 2020 guidelines on the use of surgical attire should be used (Link 2020 ), as this version was not yet published when the pilot study was conducted.…”

Association of Surgical Jacket and Bouffant Use With Surgical Site Infection Risk

“…Regulatory bodies have suggested that OR personnel cover their arms with surgical jackets and wear a "clean surgical head cover or hood that confines all hair and completely covers the ears, scalp skin, sideburns, and nape of the neck." 8 Although not explicitly stated, this has been understood by many institutions as a recommendation for bouffants and against surgical caps in an effort to decrease the risk of SSIs. 8 Our data add support to the growing body of literature suggesting that these wellintentioned regulations have not been shown to have an effect on SSIs.…”

“…8 Although not explicitly stated, this has been understood by many institutions as a recommendation for bouffants and against surgical caps in an effort to decrease the risk of SSIs. 8 Our data add support to the growing body of literature suggesting that these wellintentioned regulations have not been shown to have an effect on SSIs.…”

“…Various measures have been enacted to decrease the occurrence of SSIs involving the regulation of the attire worn by the operating room (OR) staff. The Association of Perioperative Registered Nurses (AORN) made several recommendations in 2015 8 regarding appropriate surgical attire. One notable recommendation for a "clean surgical head cover or hood that confines all hair and completely covers the ears, scalp skin, sideburns, and nape of the neck" has led to the transitioning from a surgical skull cap to an alternate head covering, such as a bouffant or hood, in many institutions.…”

“…One notable recommendation for a "clean surgical head cover or hood that confines all hair and completely covers the ears, scalp skin, sideburns, and nape of the neck" has led to the transitioning from a surgical skull cap to an alternate head covering, such as a bouffant or hood, in many institutions. 8,9 Additionally, the AORN advocated that all personnel present in the OR and not scrubbed wear surgical jackets to cover their arms at all times. The joint commission and other accrediting bodies have begun to enforce these recommendations as regulations, citing hospitals for poor infection control practice if they discovered that surgical caps were being worn in the OR.…”