Should staff wash their OR attire at home?

Are fleece jackets appropriate for the OR?

Question: I am looking for data to support washing warm-up jackets at home. We all have the same problem: If we send them to our laundry service, they never come back. Also, please give me any information on the type of material that can be worn in the OR. I have staff members who want to wear fleece jackets. I just can’t agree to this, but I need documentation. Thank you for any help you can provide. — Pam Neiderer, RN, BSN, Team Leader, Clinical Services, Surgical Center of York (PA).

Answer: The Association of periOperative Registered Nurses (AORN) does not recommend home laundering surgical attire, including warm-up jackets, says Ramona Conner, RN, MSN, CNOR, perioperative nursing specialist at the Center for Nursing Practice of AORN in Denver. The "Recommended Practices for Surgical Attire" in AORN Standards, Recommended Practices, & Guidelines (2005), p. 299, states, "Laundering of surgical attire in home laundries is not recommended." AORN recommends that all reusable surgical attire be laundered in a facility-approved and monitored commercial laundry. Commercial laundries are required to follow strict guidelines that are often not found in home laundries including:

• proper and controlled water temperatures;
• use of detergents;
• use of oxidizing agents (e.g., chlorine bleach) in specified and monitored concentrations;
• repeated changes of water;
• dryer or iron and press drying temperatures.

Although AORN does not recommended home laundering, AORN is aware that some facilities require personnel to home launder surgical attire. If health care workers are required to home launder attire, steps should be taken to protect the home environment from possible contamination. Laundering practices similar to the commercial guidelines are recommended. These steps include:

• using an automatic washer and hot-air dryer;
• using water temperatures of 110º F to 125º F;
• using chlorine bleach;
• using detergent according to manufacturer’s instructions;
• laundering surgical attire in a separate load with no other items;
• laundering surgical attire as the last load after all other items have been laundered;
• washing hands immediately after placing laundry in the washing machine;
• keeping laundry items completely submerged during the entire wash and rinse cycle;
• avoiding placing hands or arms in the laundry or rinse water to keep items submerged;
• thoroughly cleaning the door and lid of the washing machine before removing the laundered attire;
• using the highest drying setting possible that is safe for the material;
• promptly removing attire when dry.

Fleece warm-up jackets are not acceptable in the perioperative setting. The fabric used for surgical attire, which includes warm-up jackets and hats, should be nonlinting multiuse fabric. Fleece tends to lint or may harbor lint from other fabrics. Polyester, acrylic, and wool can be carriers of Staphylococcus aureus and Pseudomonas aeruginosa bacterial strains, two major pathogens commonly involved in health care-associated infections. Perioperative nurses and managers should consider this when evaluating scrubs or warm-up jackets to be used in perioperative settings. Appropriate surgical attire should be made of low-linting cotton blend fabric to minimize bacterial shedding and transmission, and provide comfort, safety, and a professional appearance.


  • Ramona Conner, RN, MSN, CNOR, Perioperative Nursing Specialist, Center for Nursing Practice, AORN, 2170 S. Parker Road, Denver, CO 80231. Phone: (800) 755-2676, ext. 264 or (303) 755-6304, ext. 264. Fax: (303) 338-5165. E-mail: