Sleeves in the OR

[ruggster]

Recently at work we have begun to implement the new AORN standards including wearing jackets in the OR around open sterile supplies. I as a circulator don't generally have an issue with new expectations coming down the pike but after this being implemented several months ago, am a bit concerned with this.

Prior to this new requirement, when I washed my hands, I washed all the way up to my elbows. Now when I wash my hands, I wash my hands to the sleeve of my jacket and that is it.

The problem is that when a patient comes into the room and we have to help them over on the bed from the stretcher or back, many times my forearms are coming into contact with the patient while rolling. The next patient receives the same treatment but I have likely not changed my jacket or washed my forearms/sleeves.

In an ideal world, I would have had the time and replaced my jacket with a clean one but in actual practice, I don't.

How do others feel about this new expectation? It was put into place to prevent the spread of contamination and infection but in reality and practice, is it?

I understand that there are a lot of practices that I may not agree on the effectiveness but I still follow them and will support their implementation but this is one that I just can't seem to wrap my head around the efficacy of it.

Anyway, if you have a moment to share your ideas or thoughts, I would love to hear them. Thanks

[orthotime]

I also agree, this was an odd decision by AORN. Moving an intubated patient, placing a foley,

prepping a leg, and so much more can't be done without the jacket touching the bed or patient.

I would need to exchange the jacket after each case.

I've read that the cuffs of doctors lab coats were found to carry bacteria from one patient to another.

Maybe someone should try culturing our jackets.

[Fun2RN,BSN, BSN, RN]

Jacket sleeves can be pushed up for prepping, and still hang down so far that the prepped area gets contaminated. I am not an advocate of jackets while prepping. I understand the dead skin side of the story, but my bare arms are not over the sterile field. If I'm scrubbing, my arms are covered.

The AORN, and medline I believe, is now introducing a long-sleeve scrub that can be worn in the OR. (No, I'm not a rep, or have stock, etc, but I really do like the idea of those scrub tops for the circulators, over pushed up jacket sleeves.)

[shodobe]

Ever think about taking off your jacket prior to doing thing around patients or washing your hands, etc... Kind of a no brainer don't you think?

[orthotime]

So shedding a little hair and skin is better than shedding a lot? I guess so but taking the jacket off at your convenience does not adhere to AORN guidelines and defeats the purpose. The tight long sleeve shirt under scrubs that never needs to be pushed up while inside the operating room does seems like a better solution to me.