The American College of Surgeons (ACS), the American Society of Anesthesiologists (ASA), the Association of peri-Operative Registered Nurses (AORN), the Association for Professionals in Infection Control and Epidemiology (APIC), the Association of Surgical Technologists (AST), the Council on Surgical and Perioperative Safety (CSPS); and The Joint Commission (TJC) met on February 27, 2018, to review and discuss the literature related to recommendations for operating room (OR) attire, specifically ear and hair covering.
On April 26, 2018, several national organizations, including the American Society of Anesthesiologists® (ASA), released a joint statement related to the Association of periOperative Registered Nurses (AORN) guideline for surgical attire. The joint statement includes clarification on ear coverage requirements and an acknowledgement on the lack of scientific evidence linking the type of hat or extent of hair coverage with Surgical Site Infection rates.
ASA members routinely encounter surgical attire guidelines locally and have expressed frustration with the evidence used to support those guidelines. In the past year, ASA has initiated a number of actions, including a close review and analysis of AORN guideline recommendations and in emphasizing recent studies related to surgical attire. In particular, the 2017 Markel study cited within the joint statement found “No significant differences were observed between disposable bouffant and disposable skull caps with regard to particle or actively sampled microbial contamination.”
The joint statement comes on the heels of a February 27 meeting between ASA, the American College of Surgeons (ACS), AORN, the Association for Professionals in Infection Control and Epidemiology (APIC), the Association of Surgical Technologists (AST) and The Joint Commission (TJC). Dr. Jeffrey Plagenhoef, M.D., FASA, ASA Past President, Dr. Lois Connolly, M.D., FASA, Chair, ASA Committee on Quality Management & Departmental Administration (QMDA) and Matthew Popovich, Ph.D., ASA Director of Quality and Regulatory Affairs attended. A primary goal of Dr. Plagenhoef’s tenure as ASA President was focused on initiating action on finding solutions to surgical attire issues that ASA members face and to emphasize the need for guidelines implemented in the operating room to be scientifically and evidence-based. The summit represented ASA’s desire to address this issue in a proactive and constructive way.
ASA embraces the joint statement’s goal that “Evidence-based recommendations on surgical attire developed for perioperative policies and procedures are best created collaboratively, with a multi-disciplinary team representing surgery, anesthesia, nursing, and infection prevention.” ASA continues to engage and work with stakeholders on solutions for local surgical attire policies.