healthcare textiles & laundry
Spotlight on Section 2.1 Fabric and the differences you can expect in the 2024 Guidelines release
healthcare textiles & laundry
By John Scherberger , FAHE , CMIP , VPEI ; and David W . Koenig , PhD
Staying Abreast of Revisions to Surgical Attire Guidelines
Spotlight on Section 2.1 Fabric and the differences you can expect in the 2024 Guidelines release
As French novelist Gustave Flaubert ( 1821-1880 ) asserted , “ The essence is often obscured by the intricacies .” Initial simplicity often belies the underlying complexity , requiring more time and effort than anticipated . The overarching theme is that the finer details hold significance . However , the original intent of words often needs to be clarified amidst a cacophony of divergent interpretations and opinions , which may need a foundation in science or reality . The creators of the Association of periOperative Registered Nurses ( AORN ) Guideline for Surgical Attire did not intend for the guidelines to be open to subjective interpretation . In healthcare , all actions should be meticulously rooted in scientific principles and infused with empathy .
Section 2.1 under Surgical Attire is explicitly about the fabrics of scrub apparel ( tops , pants , dresses , long-sleeve jackets ). AORN recognizes that significant changes have occurred since the release of the last iteration of its guideline , including transformations in textiles and blends , advancements in fiber and filament manufacturing , shifts in the operating room environment , and enhancements in operational processes and procedures . These changes have led to improved patient outcomes , safer operating room ( OR ) environments , and swifter and safer procedures , all facilitated by the collaborative efforts of manufacturers , the Food and Drug Administration ( FDA ), and healthcare professionals . Additionally , the safety and comfort of all OR staff have been considered and enhanced .
Notable advancements have occurred within the operating room environment throughout the lifespan of the 2012 AORN Guideline for Surgical Attire .
“ Many providers aren ’ t aware of the latest recommendations ,” says Lisa Spruce , DNP , RN , CNOR , CNS-CP , ACNP , ACNS , FAAN , director of evidence-based perioperative practice at AORN . “ They frequently refer to the older guidelines . Much of it has changed , so we need to emphasize that surgical teams should refer to the latest revision .”
One pivotal change has been the development of scrubs and gowns that boast tightly woven , low-linting fabric sufficiently dense to impede the escape of microorganism-carrying skin cells or their entry into the surrounding air . Checking the escape of microorganism-carrying skin cells is considered a requirement for low-permeable fabric , rather than impermeable , as it allows the body to function comfortably and without constraint .
In a recent conversation with Spruce and Karen deKay , MSN , RN , CNOR , CIC , senior perioperative practice specialist at AORN , they revealed that the forthcoming revised AORN guidelines will only incorporate changes supported by recent literature reviews conducted during the update process . AORN has not included
recommendations or requirements regarding flammability for scrub apparel , as no evidence or reports of fibers or fabric igniting in the OR due to scrub apparel were discovered .
On the other hand , surgical gowns worn within the sterile field must adhere to FDA regulations to demonstrate their safety and effectiveness , including measures related to flammability . deKay emphasized that AORN will not issue recommendations concerning material blends or percentages in the revised 2024 guidelines . In the recent literature review for this update , no recommendations for flammability requirements for scrub apparel were found , nor were case reports or studies regarding fibers or fabric igniting a fire in the OR when scrub apparel was worn .
In contrast , surgical gowns intended for use in the sterile field must meet FDA requirements for safety and effectiveness , including flammability , as stipulated in 21CFR 878.4040 Title 21 - Food and Drugs .
In the updated surgical attire guideline to be released in February 2024 , AORN will provide the following definition :
Tightly woven : material that is so dense that it is difficult for microorganism-carrying skin scales to exit or reach air . Synonym : Low permeable
Laundering . The recommendations will remain to wear clean surgical attire when entering the semi-restricted and restricted areas to protect patients from exposure to microorganisms that could contribute to an SSI . After each daily use , to launder scrub attire at a healthcare-accredited laundry facilities or onsite if your facility has the proper equipment and can meet state regulatory requirements or the CDC ’ s recommendations for laundering . Rationale in the guideline provides a review of the evidence on home laundering .
“ Outpatient surgery facilities still frequently have their staff members wash their scrubs at home ,” says Spruce . “ Home washing machines are not monitored for quality , consistency or safety , and many energy-efficient home washers don ’ t get hot enough or agitate enough .” In addition , retail detergents usually aren ’ t powerful enough to properly clean soiled scrubs .
Understanding the contents of the soon-to-be-released 2024 AORN Guideline for Surgical Attire should bring clarity to everyone who understands that they are not open to interpretations and opinions .
John Scherberger , FAHE , CMIP , T-CHEST , T-CSCT , T-CNACC , VPEI , is principal of Healthcare Risk Mitigation and a board member of he Environmental Services Optimization Project ( EvSOP ).
David W . Koenig PhD , is chief technology officer of DKMicrobios as well as a board member of the Environmental Services Optimization Project ( EvSOP ).
24 december 2023 • www . healthcarehygienemagazine . com