Next chance you get, take the "Surgical Attire Audit Tool" on the next page into your ORs and note what your staff is wearing. Chances are, you'll see unconfined hair and jewelry, Croc-like footwear with holes or open backs and dangling surgical masks — as well as other infractions of your surgical attire policy.

These infractions may seem minor, but the last thing you need is a surgical team that appears careless and unconcerned about infection control. What's more, team members who fail to wear the appropriate attire pose a real risk to patients. It's easy to forget that Staphylococcus aureus, in particular, thrives in hair and in the nares. Just as we don gloves, scrubs and masks to protect ourselves from patient blood and body fluids, we must also take steps to protect patients from our own shedding.

The best way to ensure your staff is following policies is to conduct regular checks. The "Surgical Attire Audit Tool," which you can modify to your liking, can get you started. Here's how it works:

• Make a plan. Inform your staff that you'll be inspecting their surgical attire and explain why, but conduct random, unannounced audits. Determine a compliance benchmark that you'd like your facility to attain. The audit should be done until you've achieved your benchmark. For auditing surgical attire, we recommend 100-percent compliance. Once you've attained your benchmark, perform an annual surgical attire audit.
• Appoint an auditor. You may be the best person to take on this responsibility, but if you decide to delegate the task, choose someone who'll be able to observe the team and collect data in a professional, unbiased manner. The auditor could be an educator, manager, staff member or an outside consultant.
• Communicate your findings. Once the audit tool has been filled out, review the data, share the results with any team members found to be noncompliant, and solicit feedback on why they didn't adhere to policy. If you find a consistent deviation from policy, counsel those who are failing to comply and conduct a follow-up audit. Share an overview of the results with the entire staff, including what the benchmarks were, without mentioning any individuals.

An easy fix
The OR is not a fashion show — what your surgical team is wearing should be the least of your concerns. But in reality, OR staff present a significant risk to patients if they fail to comply with the rules governing attire. Luckily, mandating and monitoring practices in this area is relatively simple once you've equipped yourself with the proper tools.