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Traffic Patterns in the OR

Attire/Dress Code in the Perioperative Services Areas

Policy #: PSM 100-101

Purpose

A dress code is needed in the surgical environment because the human body is a major source of microbial contamination. Various articles of surgical attire are worn to provide a barrier to contamination that may pass from personnel to patient as well as from patient to personnel. Perioperative Services staff are expected to project a professional appearance in the work setting.

Policy Statement

  1. It is preferred that all care providers within the Perioperative Services division wear hospital-acquired and hospital-laundered scrub attire.

  2. All persons who enter the semi-restricted and restricted areas of the surgical suite will wear scrub attire, a hat and mask when appropriate.

  3. Staff must comply with the guidelines for the use of Personal Protective Equipment as defined in policy #IC-BBP2 Standard Precautions.


Guideline(s) for Implementation:

  1. When in the operating room, it is recommended that scrub suite tops be secured at the waist, tucked into the pants, or fit closely to the body.

  2. T-shirts may be worn under scrub shirts only if completely contained within the scrub shirt.

  3. Personnel who require access to semi-restricted or restricted areas may wear jump suits. (i.e. service employees, family members observing c-sections, interpreters). Jump suits may not be worn by staff members who are giving direct patient care or are scrubbed at the field.

  4. All persons entering the restricted area of the surgical suite will wear a mask when there are open sterile items and equipment present, where scrubbed persons are located or a procedure is about to begin or is in progress. Staff will wear masks in the clean/central core of the O.R. suite when within three feet of scrubbed personnel or open sterile supplies/instruments.

  5. Hats, masks, goggles and shoe covers will be removed before exiting the OR suite. Scrub attire will be changed daily or whenever visibly soiled to reduce potential cross-infection.

PSM 100-101 Attire / Dress Code Page 1 of 2

A. Uniforms

  1. It is preferred that only scrub pants and shirts provided by the hospital and laundered by the hospital laundry service be worn in the Perioperative Services areas including the O.R., Holding Area, PACU, Pain Clinic and CPD areas. Home laundering and transport of surgical attire is discouraged as it is difficult to monitor home laundering methods and taking soiled surgical attire into the home can result in the potential spread of contamination to the home environment.
  2. Warm-up jackets may be worn, but should be removed when there is risk of contamination by blood or body fluids. Cloth jackets should be changed whenever visibly soiled.
  3. Hospital I.D. badges will be worn at all times.

B. Head-coverings

  1. Disposable caps and hoods are provided by the hospital and are disposed of after use. Cloth hats are to be changed daily or whenever visibly soiled.
  2. All hair must be covered when in a restricted or semi-restricted area of the O.R. suite.

C. Masks

  1. A single disposable surgical mask will be worn in restricted areas as described previously. The mask should cover both mouth and nose and be secured in a manner that prevents venting.
  2. Masks should be discarded when leaving the restricted area, after a procedure or when visibly soiled.
  3. Masks should be carefully removed and discarded after use by handling only the ties so that bacteria is not transferred from the mask to the hands.

D. Shoes

  1. O.R.-dedicated shoes are unnecessary. O.R. team members and visitors should don shoe covers when there it is likely that shoes will become soiled by blood or body fluids.
  2. When leaving the department, soiled shoe covers are to be removed and disposed of in a proper receptacle.

E. Jewelry

  1. All jewelry must be totally confined within the sterile scrub attire.
  2. All rings and bracelets must be removed prior to a surgical hand scrub.
  3. Earrings will be contained within the surgical cap.


Reference

2004 AORN Standards, Recommended Practices and Guidelines
Recommended Practices for Traffic Patterns in the Perioperative Practice Setting.

Vice President Sponsor:
Dianne Anderson, RN, VP, PCS

Author/Owner/Chair:
Elena Canacari, RN,
Director, Perioperative Services

Approved By:
OR Executive Committee/Date:
Josef E. Fischer, MD, Carol Warfield, MD, Dianne Anderson, RN
Co-Chairs

Contact Information

Beth Israel Deaconess Medical Center
330 Brookline Avenue, Boston, MA 02215
Main Switchboard: 617-667-7000
Find a Doctor: 800-667-5356
Directions by Phone: 617-667-3000
TDD (for hearing impaired): 800-439-0183