Aorn guideline Gap Analysis Tool: Surgical Attire



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AORN Guideline Gap Analysis Tool: Surgical Attire [Insert facility name or a header]







Meets Recommendation?


Comments/Actions

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Recommendation 1: Clean surgical attire should be worn in the semi-restricted and restricted areas of the perioperative setting.










Are the fabrics used for scrub attire tightly woven, low linting, stain resistant, and durable?










Do perioperative personnel don clean scrub attire daily?










  • Is scrub attire donned in a designated dressing area before personnel enter into the semi-restricted and restricted areas?










  • When donning scrub attire, do personnel avoid contact of the clean attire with the floor or other potentially contaminated surfaces?










  • When a two-piece scrub suit is worn, is the top of the scrub suit tucked into the pants, secured at the waist, and fit close to the body?










  • Are scrub dresses worn over scrub pants or leggings that are laundered in a health care-accredited laundry facility after each daily use and when contaminated?










  • Is personal clothing that cannot be contained within the scrub attire laundered in a health care-accredited laundry facility after each daily use and when contaminated?










In the restricted areas, do all nonscrubbed personnel completely cover their arms with a long-sleeved scrub top or jacket?










  • Do perioperative team members wear scrub attire that covers their arms while they perform preoperative patient skin antisepsis?










  • Do perioperative or sterile processing team members wear scrub attire that covers their arms while they prepare and package items in the clean assembly section of the sterile processing area?










  • Are long-sleeved jackets and scrub attire tops worn so that they fit closely to the arms and torso to prevent the jacket or top from potentially contaminating the surgical site during preoperative patient skin antisepsis or other activities (eg, application of surgical dressings)?










  • When a long-sleeved jacket is worn, is it snapped closed or buttoned up the front?










Do persons entering the semi-restricted or restricted areas of the surgical suite for a brief time (eg, law enforcement officers, parents, biomedical engineers) don either clean scrub attire, single-use scrub attire, or a single-use jumpsuit (eg, coveralls, bunny suit) designed to completely cover personal apparel?










Do perioperative personnel change into street clothes when they go outside of the building?










Is cover apparel (eg, a lab coat) worn over scrub attire clean or designed and worn for a single use?










  • Is reusable cover apparel laundered in a health care-accredited laundry facility after each daily use and when contaminated?










Do perioperative personnel wear clean shoes that are dedicated for use in the perioperative area?



















  • Are shoe covers or boots worn in instances when gross contamination is anticipated?










  • Are single-use shoe covers removed and discarded immediately after use?










  • Do perioperative personnel perform hand hygiene after removing and discarding shoe covers?










Do perioperative personnel wear surgical masks in combination with eye protection devices (eg, goggles, glasses with solid side shields, chin-length face shields) whenever splashes, spray, spatter, or droplets of blood, body fluids, or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated?










  • Are reusable eye protection devices that are worn with surgical masks cleaned according to the manufacturer's instructions for use before and after perioperative personnel perform or assist with a procedure?










  • Are surgical masks worn covering the mouth and nose and secured in a manner that prevents venting at the sides of the mask?










  • Do perioperative personnel don fresh surgical masks before they perform or assist with each new procedure?










  • Do perioperative personnel replace and discard masks when they become wet or soiled or have been taken down?










  • Do perioperative personnel avoid wearing their masks around their necks?










  • Do perioperative personnel remove and discard surgical masks by handling only the mask ties?










  • Do perioperative personnel perform hand hygiene after removing masks?










Do perioperative personnel wear identification badges that are visible and secured on the scrub attire top or long-sleeved jacket?










  • Do perioperative personnel avoid wearing badges on lanyards?










  • Do perioperative personnel clean their badges with a low-level disinfectant (eg, 70% isopropyl alcohol) regularly and when the badge becomes soiled?










Do perioperative personnel remove jewelry (eg, earrings, necklaces, bracelets, rings) that cannot be contained or confined within scrub attire when they are in the semi-restricted or restricted areas?










Do perioperative personnel avoid wearing stethoscopes around their necks?










  • Are stethoscopes cleaned before and after each use with a low-level disinfectant?










  • Is the use of fabric stethoscope tubing covers avoided?










Are briefcases, backpacks, and other personal items cleaned with a low-level disinfectant before they are taken into the semi-restricted or restricted areas?










  • Do perioperative personnel avoid placing personal items on the floor?










Are cell phones, tablets, and other personal communication or hand-held electronic devices cleaned with a low-level disinfectant according to the manufacturer's instructions for use before and after being brought into the perioperative setting?










Recommendation 2: All individuals who enter the semi-restricted and restricted areas should wear scrub attire that has been laundered at a health care-accredited laundry facility or disposable scrub attire provided by the facility and intended for use within the perioperative setting.










Is scrub attire laundered in a health care-accredited laundry facility after each daily use and when contaminated?










  • Is laundered scrub attire protected during transport to the practice setting?










  • Is laundered scrub attire transported in enclosed carts or containers?










  • Is laundered scrub attire transported in vehicles that are cleaned and disinfected regularly?










  • Is laundered scrub attire stored in enclosed carts or cabinets that are cleaned and disinfected regularly?










  • If laundered scrub attire is stored in dispensing machines, are the machines cleaned and disinfected regularly according to the manufacturer's instructions for use?










Is reusable scrub attire left at the health care facility for laundering?










  • Is scrub attire that has been penetrated by blood, body fluids, or other potentially infectious materials removed as soon as possible and replaced with clean attire?










  • Is scrub attire that is contaminated with visible blood, body fluids, or other potentially infectious materials laundered at the health care facility or sent to a contracted health care-accredited laundry facility?










  • Is wet or contaminated scrub attired rinsed and sorted in a location other than the location of use?










  • Do perioperative personnel avoid storing reusable scrub attire that has been worn in personal lockers for later use?










  • Is contaminated scrub attired (either reusable or single use) placed in designated containers after use?










Recommendation 3: Personnel entering the semi-restricted and restricted areas should cover the head, hair, ears, and facial hair.










Do perioperative personnel 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?










  • Do personnel wearing scrub attire leave their surgical head coverings on when leaving the perioperative area?










  • Do personnel remove their surgical head coverings when they leave the health care facility or travel between buildings located on separate campuses?










  • Are used single-use head coverings removed at the end of the shift or when contaminated and discarded in a designated receptacle?










  • Are reusable head coverings laundered in a health care-accredited laundry facility after each daily use and when contaminated?












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