The goal of using the proper surgical attire is to reduce microbial contamination throughout the continuum of care in the surgical suite to prevent surgical site infections. The proper surgical attire should be worn in the semi-restricted and restricted areas of the facility.
QUAD A standard 7-A-10. has new interpretive guidance. Wearing scrub attire that is laundered at a healthcare–accredited laundry facility or at the facility in accordance with state regulatory requirements and nationally recognized guidelines and standards of care provides control of the laundering process and helps ensure that effective laundering standards have been met.
Home laundering of surgical attire is not recommended because laundering is not monitored for quality, consistency, or safety. Home washing machines may not have the adjustable parameters or controls required to achieve the necessary thermal measures (e.g., water temperature), mechanical measures (e.g., agitation), or chemical measures (e.g., capacity for additives to neutralize the alkalinity of the water, soap, or detergent) to reduce microbial levels in soiled scrub attire.
The Association for Professionals in Infection Control and Epidemiology (APIC) recommends that personnel entering the semi-restricted and restricted areas of the surgical/procedural suite should wear clean scrubs laundered in a healthcare-accredited laundry facility in accordance with facility policy. Personnel should don clean scrubs daily. Generally, per industry standards of practice, it is recommended that operating staff change from street clothes into scrubs once they arrive at work and remove them before leaving the facility at the end of the day.
QUAD A standards do not specify how facilities handle scrubs. The facility must have a policy that describes the practice based on state requirements and nationally accepted guidelines. However, keep in mind, per OSHA Bloodborne Pathogen Standards, if the employee’s scrubs become soiled with blood or other potentially infectious materials while working, the employer is required to clean this attire at no cost to the employee.
State Public Health Departments may have requirements regarding scrub attire. Some states require ambulatory surgery facilities to provide facility-laundered scrubs for healthcare workers working in restricted or semi-restricted areas. Please verify with your State Public Health Departments if there are any requirements in your location. You may consider performing an infection control risk assessment to determine best practices based on the types of procedures performed in your facility.
Below are some additional resources that may be helpful:
- APIC Infection Preventionist’s Guide to the OR (2015)
- AORN Guidelines – access may require a paid membership.
- CDC Guidelines for Environmental Infection Control in Health-Care Facilities (2003)
- Most Frequent-Asked Questions Concerning Bloodborne Pathogens Standard
If you have any further questions, please feel free to submit them to standards@QuadA.org.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
