Page 170 - Assurance of Sterility for Sensitive Combination Products and Materials

152 Assurance of sterility for sensitive combination products and materials

a surgical patient might have. What is not as well understood is that it is
also necessary to protect patients from exposure to infectious diseases from
HCWs. This requires that we look at the attire of HCWs in both surgical
and nonsurgical settings.

6.5.3.3 Nonsurgical setting attire
Though the role of hospital attire in causing HAIs is not clear, some
recommendations have been provided by the Society for Healthcare
Epidemiology of America (SHEA) for HCW attire in nonsurgical settings.
These recommendations are based on practical, theoretical, and biolog-
ically plausible considerations. HCWs should wear short sleeves, i.e., be
bare below the elbows (BBE) during patient contact. This includes wearing
no jewelry or neck ties below the elbows, e.g., watches, rings, bracelets, etc.
If neckties are worn the tie should be secured so that direct patient contact
will not occur.
Foot wear should be closed toes with low heels and nonskid soles. Closed
toed shoes can prevent blood and other body fluids from contaminating the
feet. Shared patient equipment, e.g., stethoscopes should be cleaned be-
tween patients. Personal items, e.g., neckties, lanyards, pagers, jewelry, and
phones, should be disinfected between patients, and replaced or not used if
they become contaminated.

6.5.3.4 Surgical setting attire
Surgical attire should be worn in semi-restricted and restricted areas of the
OR. This includes:
• head cover, to prevent shedding of hair, squamous cells, and dandruff,
• facial mask and safety eye wear
• scrub suit,
• warm up jacket, and
• shoe covers.
Head covers should completely cover the hair and be lint free. Facial
mask and safety eye wear should always be worn when in restricted areas. A
clean scrub suit should be worn each day. The fabric should be low linting,
comfortable, breathable and contain shedding of skin cells. The shirt should
be tucked into contain skin cells. Shoe covers are used to protect the sterile
surgical team members’ shoes from contamination from blood, body fluids,
and other fluids. These should not be worn outside the OR semi-restricted
and restricted areas. In some ORs it is acceptable to wear dedicated shoes
instead of shoe covers.