Becker's Clinical Quality & Infection Control

47 INFECTION CONTROL & PATIENT SAFETY American College of Surgeons Issues New Dress Code By Emily Rappleye T he American College of Surgeons issued new guide- lines Aug. 8 on appropriate surgeon attire in and out of the operating room. "It's important to provide an optimal surgical care environ- ment for our patients. These recommendations for a com- prehensive dress policy for surgeons will help us to achieve that goal," ACS Executive Director David Hoyt, MD, said in a statement. The guidelines are based on "professionalism, common sense, decorum and the available evidence," according to ACS. Dress code recommendations include: • Changing scrubs and hats after a surgical procedure before speaking with family members • Changing scrubs and hats before subsequent cases even if they are not visibly dirty • Covering OR scrubs with a clean lab coat when outside the OR area • Limiting scrub wear to the hospital facility • Covering the mouth, nose and hair during invasive pro- cedures. A limited amount of hair on the back of the neck and/or "modest" sideburns are allowed to show n Should Antimicrobial Curtains Be Cleaned Between Patients? By Heather Punke A fter a hospital in Milwaukee, Wis., switched all of its curtains to an antimicrobial fabric, it changed policies to only clean or exchange curtains if they were visibly soiled. But that amend- ment may have been too hasty, according to a study submitted as a letter to the editor of Infection Con- trol & Hospital Epidemiology. Physicians at the 650-bed hospital collected samples from 20 curtains in 10 patient rooms in the medical intensive care unit, located at the entry glass door and surrounding the commode. The curtains had been pretreated with a silane-based technology to help prevent bacterial growth. Of the 20 samples, 95 percent showed bacterial growth. Gram-negative bacteria were present on 50 percent of the door curtains and 10 percent of the commode curtains. "Like other objects in patient rooms, we believe that curtains should be thoroughly disinfected or exchanged in between patients or should be totally avoided," the letter reads. "The use of antimicrobi- al curtains should not preclude the disinfection of these surfaces upon terminal cleaning." n AORN Responds to ACS' New Surgeon Dress Code Statement By Heather Punke T he Association of periOperative Registered Nurses has taken issue with parts of the American College of Surgeons' new guidelines on appropriate surgeon attire, which were released Aug. 8. Of particular issue to AORN is that ACS said its guidelines were based on "profes- sionalism, common sense, decorum and the available evidence." AORN believes guide- lines should be solely based on evidence. AORN took issue with the following three tenets of ACS' guidelines: • "Scrubs and hats worn during dirty or con- taminated cases should be changed prior to subsequent cases even if not visibly soiled." According to AORN, evidence shows that if following proper precautions and using personal protective equipment, scrubs shouldn't have to be changed between cases. "is statement may cause confusion by introducing a different standard for surgeons than for other perioperative team members," an AORN statement reads. • "During invasive procedures, the mouth, nose and hair (skull and face) should be covered to avoid potential wound contamination. Large sideburns and ponytails should be covered or contained. ere is no evidence that leaving ears, a limited amount of hair on the nape of the neck or a modest sideburn uncovered contributes to wound infections." According to AORN, "until an evidence-based definition of 'limited' or 'modest' can be determine[d], there is no way for facilities to enforce such a recommendation." • "e skullcap is symbolic of the surgical pro- fession. e skullcap can be worn when close to the totality of hair is covered by it and only a limited amount of hair on the nape of the neck or a modest sideburn remains uncovered. Like OR scrubs, cloth skull caps should be cleaned and changed daily. Paper skull caps should be disposed of daily and following every dirty or contaminated case. Religious beliefs regarding headwear should be respected without compromising patient safety." AORN disagrees with the last element of this point. "Head coverings based on sym- bolism and a personal attachment to histori- cal norms have no place in the patient benefit analysis expected of guideline developers by the National Guidelines Clearinghouse," AORN states. n

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