AORN's Updated Surgical Attire Guidelines: Enhancing Patient Safety in the OR

Maintaining a hygienically clean environment is paramount—inside and outside of the operating room. Proper infection control protocols extend beyond the OR—to the hallways, changing rooms, and even our communities. That's why AORN’s updated guidelines for surgical attire are so crucial. These standards address the vital role attire plays in minimizing the risk of surgical site infections (SSIs) for patients, while also protecting healthcare workers and preventing the spread of microorganisms throughout the entire healthcare facility.

Why Updated Surgical Attire Guidelines are Crucial for Infection Prevention

These revisions address everything from lanyards and cell phones to head coverings and shoe covers, reflecting the latest evidence-based research and best practices. This isn't just about what you wear; it's about creating a consistently safe environment for every surgical procedure.

Addressing Lanyard Contamination in the Perioperative Setting

One significant update focuses on the often-overlooked issue of lanyards. Research has revealed that lanyards, particularly those made of nylon and polyester, can harbor harmful pathogens. One study even found a direct link between bacteria on healthcare workers' lanyards and bacteria in their nasal passages, highlighting the potential for contamination. AORN now recommends that interdisciplinary teams, including infection preventionists, perioperative personnel, anesthesia providers, and surgeons, carefully evaluate the use of lanyards in the perioperative setting. If lanyards are deemed necessary, strict protocols for cleaning and disinfection must be implemented to minimize the risk of infection.

The Impact of Cell Phone Hygiene on Surgical Site Infections

Another area of concern is cell phones. We all know how attached we are to our devices, but studies show we touch them over 200 times a day! This constant contact, combined with the warmth generated by cell phones and the presence of cracks and crevices in screens and cases, creates an ideal breeding ground for microorganisms. AORN's updated guideline emphasizes the importance of frequent hand hygiene when handling cell phones throughout the day, recognizing that simply cleaning the device once isn't enough to mitigate the risk of contamination.

Cleaning and Disinfecting Personal Items in the Operating Room

Beyond lanyards and cell phones, the updated guideline also provides recommendations for cleaning and disinfecting other personal items brought into the perioperative area, such as ID badges, access cards, and electronic devices like tablets. AORN suggests implementing several strategies to improve compliance with cleaning and disinfection protocols, including integrating standardized processes into daily workflows, ensuring easy access to necessary supplies like disinfectants and hand rubs, developing visible reminders with clear instructions, and educating personnel about the risks of cross-contamination from these devices. A compelling case study demonstrated the effectiveness of cleaning by showing healthcare personnel the bacterial growth on a petri dish before and after cleaning their cell phone.

Implementing AORN's Surgical Attire Guidelines: Overcoming Challenges

Implementing these updated guidelines may present some challenges. Karen deKay, Senior Perioperative Practice Specialist at AORN, highlights the need for interdisciplinary collaboration to determine circumstances that may necessitate changing of surgical attire when returning to the OR after being in different areas of the facility and to make informed decisions about lanyard use. She also acknowledges the difficulty of changing ingrained habits, particularly when it comes to cell phone hygiene. However, she emphasizes that a comprehensive approach, including education, standardized processes, resource allocation, and continuous monitoring with real-time feedback, is crucial for successful implementation.

The Benefits of AORN's Surgical Attire Updates for Patient Outcomes

The anticipated impact of these updated guidelines on patient outcomes is significant. By minimizing the introduction of pathogens from surgical attire, lanyards, personal devices, and other fomites, healthcare facilities can reduce the risk of surgical site infections and other healthcare-associated infections. Furthermore, the recommendation to change surgical attire before leaving the facility at the end of the day helps prevent the spread of potentially harmful microorganisms to public places and into the homes of perioperative personnel.

AORN's Surgical Attire Guidelines: Protecting Patients and Perioperative Teams

AORN's updated surgical attire guideline is a valuable resource for all members of the perioperative team. Surgical attire is important for infection prevention, both within and outside the operating room. Inside the OR, proper attire is crucial for maintaining a hygienically clean environment and minimizing the risk of surgical site infections, while outside the OR, changing out of contaminated attire before leaving at the end of the day prevents the spread of microorganisms. The AORN guidelines offer evidence-based practice to standardize care and improve patient outcomes. The updated guideline can be found in eGuidelines+, as well as the 2025 print guideline book and ebook.