While surveying organizations, I have noticed that many Operating Rooms and Ambulatory Surgery Centers’ Infection Control Plans state that they are following the AORN Guidelines in their surgical areas, specifically as it pertains to surgical attire. Frequently, observations in these areas contradict that statement. It is important to note that if an organization says that it follows the AORN Guidelines for Surgical Attire, it means that whether the guidelines are categorized as recommended, conditionally recommended, or regulatory requirements, the organization should be following them. Those guidelines that are categorized as regulatory requirements are the easiest to comply with. Those guidelines that are categorized as recommended or conditionally recommended must either be followed or there should be at a minimum a risk assessment completed by the organization indicating that the organization has assessed and found that there is little or no risk to the safety of their patients or the quality of care given. It is important to remember that the AORN Guidelines are evidence-based, and the references are noted at the end of each chapter. Some examples of observations made that may require a risk assessment in your organization may include:
- Laundering surgical scrubs/jackets/hair coverings at home
- Not changing into surgical scrubs at work/changing into street clothes at the end of the shift
- Wearing short sleeves while performing a surgical skin prep
- Not wearing a beard cover
- Failing to wear a hair covering properly (all hair should be in the cap)
- Wearing jewelry when scrubbing
- Non-designated OR shoes without shoe covers
- Bringing personal items, e.g. briefcases, duffel bags, and the like, into the OR room
Bottom line: Review the AORN Guidelines and perform your internal risk assessments when you decide to not follow these evidence-based recommendations.
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