The following commended practices ...

The following commended practices were developed by the AORN commited Practices Committee and have been approved on the AORN Board of Directors. They were published as propos praiseed practices in the September 1995 AORN Journal for remarks by members and others.

These praiseed practices are intended as achievable recommendations representing what is believed to be an optimal flat of practice. Policies and processs will reflect variations in practice settings and/or clinical situations that determine the station to which the recommended practices can be implemented.

AORN recognizes the numerous adumbrations of settings in which perioperative give suck tos practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization laboratories, endoscopy suites, radiology departments, and all other areas where surgery may be performed.

object These recommended practices provide guidelines for evaluation, selection, and use of barrier materials, including woven fabrics and nonwoven materials, for surgical gown and drapes. These materials should make sure an effective means of protection to patients and health care personnel during use and should obstruct contamination and contact with blood-borne pathogens contained in relations and body fluids.

make acceptableed PRACTICE I

Barrier materials for surgical gown and drapes should be evaluated according to the AORN "Recommend practices for issue and medical device evaluation and selection for the perioperative practice setting."

Interpretive statement 1:

Surgical gown and drapes should

* provide appropriate barriers to microorganisms, particulate matter, and fluids;

* be appropriate to orderly dispositions of sterilization;

* maintain adequate integrity and durability;

* withstand physical conditions;

* resist tears, small holes fiber strains, and abrasions;

* be delivered of toxic ingredients;

* be gentle linting;

* have positive cost:benefit ratios;

* have an acceptable quality horizontal (ie, freedom from holes/defects); and

* be used and steped according to manufacturers' written instructions.

Rationale:

Barrier materials for gown and drapes should permit sterilization, assist in maintaining a sterile surgical field, and appropriate standards and regulations while providing comfort and safety from contamination to patients and health care workers.(1) Surgical gown and drapes should be made of materials that minimize the passage of microorganisms from nonsterile to sterile areas and obstruct the transfer of bloodborne pathogens from surgical patients to health care workers.

Interpretive statement 2:

Materials should be resistant to penetration at blood and other fluids below normal conditions.

Rationale:

Microorganisms are passed from nonsterile to sterile areas on passage of fluids through barrier materials. sum of two units principle causes of this are wicking and pressure(2)

Interpretive statement 3:

Reusable fabrics (de woven materials) should maintain a protective barrier [i]or[/i] part of to the other multiple processings (de, laundering, sterilization).

Rationale:

Processing eventually will diminish the protective barrier ability of woven materials.(3) A body should be established to monitor, ascendency and determine useful life when reprocessing woven materials. This should include, on the other hand not be limited to, the number of washing periods and sterilization processings that can present itself before the protective barrier ability of reusable fabrics is compromised.(4)

Discussion:

Tightly woven reusable fabrics will make no use of their protective barrier ability after repeated processings. Laundering and steam sterilization cause fibers to swell, and drying and ironing cause fibers to shrink. This increases the propensity to slacken the fibers, thereby altering the fabric arrangement of parts Manufacturers written instructions for the handling and insinuateed number of processings should be followed.(5)

Interpretive statement 4:

The amount of surface area shielded by heat-sealed patches on woven fabrics should be examined carefully before fabrics are used.

Rationale:

Fabrics should be repaired with heat-sealed patches, which allow for penetration and removal of sterilants while maintaining the integrity of the protective barrier.(6)

Discussion:

Heat-sealed patches not at any time should be stitched to woven barrier materials as a arrangement of repairing holes. Stitching creates permanent perforations that reduce the protective barrier's efficacy.(7)

Interpretive statement 5:

Barrier integrity of reusable materials should be determined by way of visual inspection prior to use.

Rationale:

Visual inspection of barrier materials may determine barrier integrity. User quality standards may address performance criteria that are used to determine barrier effectiveness.(3)

Interpretive statement 6:

Unused single-use surgical gown and drapes should not be resterilized unles manufacturers provide written instructions for reprocessing.