These posts are from OR Nation’s Listserv – join the conversation, visit www.theornation.com

Gossip in the OR
When the OR is busy everyone gets along fine, but when the OR is slow, people are quick to start gossiping. Any suggestions on how to stop the gossip mill?

A: This is such a true statement and if anyone has been successful handling this issue please share.

A: Have a downtime list of duties to assign like:

  • Cleaning out dusty bins
  • Checking outdates
  • Restocking rooms to PAR levels
  • Updating preference cards
  • Putting away supplies tucked/stashed in areas where they don’t belong
  • Techs cross train to sterile processing/or float to help out
  • RNs can help make post op calls for SDS
  • RNs and techs cross train in GI and
  • Create Unit Base Councils (UBC) to work on projects to help the future of your OR’s function

These are just a few ideas off the top of my head. I hope it planted the seeds for a few ideas.


Bouffant Or Surgical Skullcap?
AORN and the CDC recommend hair be covered to promote patient safety and decrease the risk of surgical site infection. AORN does not recommend one type of head covering over another. Do you prefer a bouffant or surgical skullcap?

A: Here is a snapshot of the AORN Guidelines for Head Coverings. Of interest, there is conflicting evidence about head covering but this should guide our practice:  “researchers concluded that the ears should be covered by surgical head covers during surgery.” The skullcap will not adequately do this.A: Here is a snapshot of the AORN Guidelines for Head Coverings. Of interest, there is conflicting evidence about head covering but this should guide our practice:  “researchers concluded that the ears should be covered by surgical head covers during surgery.” The skullcap will not adequately do this.

Recommendation III

Personnel entering the semi-restricted and restricted areas should cover the head, hair, ears, and facial hair.The benefit of covering the head, ears, and hair is the reduction of the patient’s exposure to potentially pathogenic microorganisms from the perioperative team member’s head, hair, ears, and facial hair.

• III.a. A clean surgical head cover or hood that confines all hair and completely covers the ears, scalp skin, sideburns, and nape of the neck should be worn. [2: Moderate Evidence]

A literature review by McHugh et al identified several conflicting studies related to the need for a surgical head covering. The authors concluded there was little evidence to suggest that covering the hair reduces SSI rates; however, they acknowledged that surgical team members wearing head coverings decreased bacterial contamination of the surgical field.

• Owers et al conducted a nonexperimental study in which 20 OR team members had their foreheads, eyebrows, and ears cultured. The researchers found there was significantly more bacteria isolated from the ears than from the foreheads and eyebrows of the surgical team members. The researchers concluded that the ears should be covered by surgical head covers during surgery.

° III.a.1. Personnel wearing scrub attire should not remove the surgical head covering when leaving the perioperative area. [4: Benefits Balanced with Harms]

The purpose of the head covering is to contain hair and minimize microbial dispersal. When the head covering is removed, hair and microbes may be shed onto scrub attire.

Head coverings commonly used in the perioperative setting (eg, bouffant caps) are worn for hair and skin containment and are not considered PPE. The Occupational Safety and Health Administration requires that PPE not permit blood, body fluids, or other potentially infectious materials to pass through or reach the employee’s clothing, skin, eyes, or other mucous membranes under normal conditions of use

° III.a.2. Personnel should remove surgical head coverings whenever they change into street clothes and go outside of the building. [4: Benefits Balanced with Harms]Removing surgical head coverings when exiting the building decreases the possibility of contamination with microorganisms present in the external environment.

° III.a.3. Used single-use head coverings should be removed at the end of the shift or when contaminated and should be discarded in a designated receptacle. [4: Benefits Balanced with Harms]

° III.a.4. Reusable head coverings should be laundered in a health care-accredited laundry facility after each daily use and when contaminated (see Recommendation II.b). [2: Moderate Evidence]

Head coverings are part of the scrub attire.