Surgical masks and other little tidbits

1
Surgical masks and other little tidbits

• Dress Code in the OR
• In-service
• March 21, 2007
• L.Dupuis

2
References

• ORNAC (2003). Recommended Standards, Guidelines
  and Position Statements for Perioperative Nursing
  Practice
• AORN (2007). Standards, Recommended Practices and
  Guidelines
• CHEO Dress Code policy

3
Preamble

• Practices that are achievable representing
  optimal level of practice
• Human body is a major source of microbial
  contamination in the surgical environment
  (restricted, controlled area)
• Attire must promote a high level of cleanliness
  and hygiene

4
Surgical masks

• All personnel shall wear a single well-fitting
  surgical mask during procedures and/or in the
  presence of open sterile supplies and equipment

5
What changes?

• No need to wear surgical mask in central core
  unless
• Close to someone who is scrubbing
• Close to open Flash Pack
• No need to wear surgical mask in the OR unless in
  presence of open sterile supplies
• Includes dental
• Effective immediately

6
N95

• To be worn when airborne infection is suspected
  or confirmed
• TB
• Personnel to be fit tested every 2 years through
  Occ Health
• YOU are responsible for maintaining your fit

7
How

• Mask shall cover the nose and mouth and be
  adjusted to prevent venting
• Masks SHOULD NOT hang around the neck or be
  stored in pockets
• Masks should be removed by handling ties only and
  discarded. Hands should be washed
• Contain bacteria collected from the
  nasopharyngeal airway

8
Eyewear

• Protective eyewear/goggles or face shields to be
  worn by the scrub team
• Unscrubbed personnel should wear protective
  eyewear as spray or splash may occur at any time
• Reusable eyewear shall be cleaned after use

9
Scrubs

• All individuals who enter the semi restricted and
  restricted areas of the surgical suite shall wear
  freshly laundered surgical attire intended for
  use only within the surgical suite
• Helps contain bacterial shedding and promotes
  environmental control
• As personnel move, friction between clothing and
  bodies frees bacteria

10
Jewellery

• All jewellery including watches and rings shall
  be removed or confined
• Jewellery harbours organisms
• Skin underneath rings is more heavily colonized
  than skin on fingers without rings
• Necklaces and earrings produce shedding and may
  fall on the outside of the sterile scrub gown
  into the sterile field or wound
• CHEO ID necklacewhen was the last time you
  washed yours???..

11
Head Cover

• All hair (including facial hair) shall be
  confined by a clean hood or hat
• Hair attracts, harbors and sheds bacteria (acts
  as a filter when left uncovered)
• Hair covers eliminate possibility of hair or
  dandruff being shed
• Disposable bouffant and hood-style covers are
  preferred
• Skullcaps that fail to cover the side hair above
  the ears and hair at the nape of the neck not to
  be worn

12
What this entails

• Major change
• Lots of resistance from many professionals and
  allied health workers
• Surgeons, Anesthesiologists, Anesthesia Nurses,
  RTs, PSAs, Students, Residents, Fellows,
  Visitors.
• Hair covering for patients too
• Who will do this?

13
Shoes

• Should be clean and fluid resistant
• Should provide protection
• Provincial labour codes
• Shoe covers provide personal protection and
  prevent environmental contamination outside the
  OR
• What about Crocs???

14
Cover apparel

• Lab coat / other to be used when leaving 3rd
  floor
• Must don fresh scrubs after each trip to other
  areas if you dont
• Time-consuming
• Increases costs

15
To summarize

• We all have a professional responsibility towards
  patient care quality
• We must create and maintain the best possible
  environment for all of our patients
• We are all concerned with patient safety and
  commit to it
• Patient safety culture
• These are our standards and we must follow them
• Researched, data based

16

• Individual commitment, professional conscience
  and the setting in which perioperative nursing is
  practiced must guide us in implementing standards