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Dear Physician,

We appreciate your dedication to high-quality outcomes for your patients and to North Kansas City Hospital. In order to protect patients against infection rates and protect you and your family from the conditions you might encounter, an updated surgical attire policy will go into effect Monday, Sept. 2. This policy will affect physicians, vendors, students, employees and ancillary staff who work in the Cardiac Cath Lab, Interventional Radiology, Main Hospital Surgery, Pavilion Surgery, cardiovascular surgical suites and 7th Floor C-section suites.

Thanks in part to North Kansas City Hospital's Ortho-Spine Co-Management group, who raised the issue, and Association of periOperative Registered Nurses (AORN), who helped create the following policies for North Kansas City Hospital:

  • Anyone entering or re-entering semi-restricted and restricted areas need to wear facility-owned, clean, freshly laundered or disposable surgical attire daily in a designated dressing area.1
  • Cloth head coverings may be worn only if a disposable bouffant hat is covering it and changed daily.
  • It is possible for fabrics to become vectors for the spread of microorganisms. Therefore, healthcare professionals should change into street clothes whenever they leave the Hospital campus, or when traveling between buildings located on campus that requires you to go outside.
  • Fannypacks, backpacks and briefcases should be non-porous and wiped down with a CaviWipe before being taken into the semi-restricted or restricted areas.2
  • All head and facial hair, including sideburns and the nape of the neck, should be covered when in the semi-restricted and restricted areas.3
  • Shoe covers or dedicated shoes for the area should be worn. Shoe covers may be worn outside the department.4
  • Jewelry should be covered with attire, rings should be limited with attention paid to washing under them.5
  • The use of disposable gowns, blankets or other cover apparel is prohibited. A scrub jacket or lab coat will be provided to cover scrub attire when desired, whether for protection or comfort.6
  • A clean mask should be put on before each procedure. Masks should not be worn hanging from the neck and out of the department.
  • Red disposable hats will be supplied for vendors. This will allow for easy identification and ensure proper attire. Hats will be available within the department and will be worn at all times they are in the sterile areas. 

We look forward to working with you to continue to provide the best care possible to your patients. If you have any questions about the surgical attire policy, please contact April Patten, director of Surgical Services, at (816) 691-5311.

Sincerely,  

Dr. Carter 

 

Gary Carter, MD
Chief Medical Officer

1In an AORN study of bacterial contamination of home-laundered uniforms, 39% identified as clean were actually found to be contaminated with one or more microorganisms, including the multi-drug resistant organisms:  Vancomycin Resistant Enterococcus (VRE), Methicillin Resistant Staph Aureus (MRSA) and Clostridium difficile.

2In Case Western News Release, June 25, 2012:  A healthy young boy was infected with MRSA that was traced to his mother’s nurses bag that had been left in the family car. The mother was a Home Health nurse who had visited a patient with the same infection. Transmission of MRSA occurred by indirect contact.

32004 study by Owens: 20 OR team members had their foreheads, eyebrows and ears swabbed. There were significant numbers of organisms colonized including staph aureus, coagulase negative staph, diptheroid and others; the ear being the worst.

4Study by the Royal College of Surgeons of England (2007): To assess the level of bacterial contamination of OR shoes at the beginning of the work day compared to outdoor shoes. Conclusion: Outdoor shoes were contaminated with staph, coliforms, bacillus, diptheroid, nisseria, and micrococcus. The dedicated OR shoes had much less of these microorganisms than outside shoes.

5AORN case:  Earrings had bacterial counts more than 21 times higher beneath the earrings than on the surface of the earrings.  Bacterial counts were 9 times greater on the skin beneath finger and nose rings than on the rings themselves.

6Fleece is highly flammable and harbors dust and skin squames. Surgical attire does not include clothing that extends above the top neckline or below the sleeves.