AORN deletes guidance for home laundering

Revised recommended practice released

In its previous "Recommended Practice for Surgical Attire," the Association of periOperative Registered Nurses (AORN) didn't recommend home laundering, but for those facilities that did it, it offered some guidance on how to do it as safely as possible. AORN has changed its stance in its just-revised recommended practice (RP).

"In the new edition, as we did the literature review and looked into the issue, we found there is no way to provide guidance for safe laundering at home," says Ramona Conner, RN, MSN, CNOR, manager of standards and recommended practices at AORN.

The new edition more strongly recommends not only industrial laundering of surgical attire, but also laundering by a laundry accredited by the Healthcare Laundry Accrediting Council (

One area that was re-emphasized discusses disposable and reusable head coverings.

"Reusable hats are very popular," Connor says. Staff members often feel strongly about these hats because they allow individuality and are considered more attractive than bouffant cap. "We consider the hat part of the surgical attire," Connor says. "If you wear a reusable cloth hat, it needs to be laundered by a healthcare laundry facility, just as the other attire is."

AORN also gives a new recommendation on quality assurance monitoring of laundering processes.

AORN also made the following changes in its revised RP:

• Safe surgical attire fabrics.

The new information includes recommendations that fabrics should be tightly woven, stain resistant, and durable. It also says that 100% cotton fleece should not be worn.

• Safe footwear.

"We recommend, in accordance with the OSHA [Occupational Safety and Health Administration] regulation, closed toe, nonskid soles," Conner says.

Previously, a reference to the OSHA requirement for construction workers misled some health care workers to think AORN was recommending steel-toed shoes for the OR, which it was not.

• Jewelry.

There is more information on wearing of jewelry, including how, where and when jewelry can be worn. AORN more clearly and specifically states what jewelry can be work at what points of entry. "For example, jewelry worn into restricted area of OR should be confined or contained under the surgical attire," Connor says.

• Stethoscopes and identification badges.

"Those personal items need to be cleaned," Connor says. "They need to be cleaned when they become soiled and on a routine basis." Stethoscopes can be contaminated by contact with patient, she points out.

• Bags carried in from outside.

A new recommendation says that fanny packs, brief cases, and backpacks should not be taken into semi-restricted or restricted areas.

This recommendation created a great deal of controversy, Connor says. "We just don't know what contaminants and vectors can be possibly carried into a restricted area of OR on these materials," she says. "You can get infections into the OR from outside."


The Recommended Practices for Surgical Attire can be ordered online from the Association of periOperative Registered Nurses (AORN) at Under "Practice Resources" select "AORN Standards and Recommended Practices" then "Order your eDocument today." Or call AORN Customer Service at (800) 755-2676, Ext. 1. The member price is $55, and the nonmember price is $95.