Association of AORN’s OR attire policy with SSIs, costs

Editor's Note

Implementation of AORN’s 2015 guidelines for OR attire, which also were adopted by the Centers for Medicare and Medicaid Services, has not decreased surgical site infections (SSIs) and has increased healthcare costs, this study finds.

For the study, data were collected on general, cardiac, neuro-, orthopaedic, and gynecologic surgical procedures from the January 2014 to November 2017 reports of the National Health Safety Network from two campuses of the New York Presbyterian Hospital, Weill Cornell Medicine, New York City. SSI rates and microbilogical culture data for 30,493 procedures before and after policy implementation were compared, and the associated costs for the AORN policy were analyzed.

The rate of SSIs did not differ between the before policy change (BC) group and after policy change (AC) group (1.0% AC vs 1.1% BC), and there was no difference in the incidence of Staphylococcal species cultured from wounds (19.3% AC vs 16.8% BC).

The cost of attire for 1 person increased from $0.07 to $0.12 before policy changes to $1.11 to $1.38 after policy change. Use of the mandated OR long-sleeved jackets alone was associated with an added cost of $1,128,078 annually, which translates to $540 million per year for all US hospitals combined.

The data suggest that the traditional OR attire policy is equally as effective and less costly than the one required by the AORN policy, the authors say.