美国ACS关于手术室着装的最新声明
2016年7月份，美国ACS（American College of Surgeons）批准发布了关于手术室着装的最新声明。ACS的核心价值观是专业、优秀、包容、创新和自省。本着以上原则以及手术室着装可能引起的医院感染情形更新此声明。
ACS关于在手术室穿着合适的工作服是基于专业、常识、礼仪以及已有证据。具体指南内容如下：
1. 尽可能更换被污染的刷手衣和帽子，尤其是在手术结束后与家属交谈前。
2. 完成一例污染病例的手术操作后，在下一例病人手术前应及时更换刷手衣和帽子，即使无可见污染。
3. 任何时候都不应将口罩悬挂在脖颈上。
4. 如需穿手术衣出手术区域时，应穿实验室工作服或合适的工作装
5. 任何时候离开医院时均不应穿刷手衣。
6. 手术室刷手衣应至少每日更换一次。
7. 实施侵入性操作时，应遮盖口鼻和头发以避免潜在的伤口感染。留有长发和马尾辫应遮盖或束起。目前尚无证据表明裸露耳朵、少许后颈或鬓角头发会增加伤口感染的风险。
8. 手术时应去除或遮盖头颈部的饰物，以防他们落入或污染无菌区域
*ACS鼓励医务人员在手术区域外见病人时穿戴干净、合适和专业的工作服。
*无沿帽是手术专业化的标志。当医务人员头发需要遮盖时，以及当医务人员少许头颈或鬓角头发无法遮盖时，应佩戴无沿帽。与手术衣相似，无沿布帽应每天清洁与更换。无沿纸帽每天及时更换，且在遇有污染病例时及时更换。
*由于不同工种的医务人员在手术室内均穿刷手衣。ACS强烈建议医务人员离开医院时不应穿戴刷手衣。为了推动本指南的实施，ACS建议手术室工作人员穿戴独特的彩色服装。
原文如下：
The following statement was developed by an American College of Surgeons (ACS) task force on operating room (OR) attire and approved by the ACS Board of Regents in July 2016.
The values of the ACS include professionalism, excellence, inclusion, innovation, and introspection. Appropriate attire is a reflection of professionalism and is integral to establishing and maintaining a patient-physician rapport based on trust and respect. In addition, insofar as clean and properly worn attire may decrease the incidence of health care-associated infections, it also speaks to a desire and drive for excellence in clinical outcomes and a commitment to patient safety.
The ACS guidelines for appropriate attire are based on professionalism, common sense, decorum, and the available evidence on this topic. Specific guidelines are as follows:
1. Soiled scrubs and hats should be changed as soon as feasible, particularly before speaking with family members after a surgical procedure.
2. Scrubs and hats worn during dirty or contaminated cases should be changed prior to subsequent cases, even if not visibly soiled.
3. Masks should not be allowed to hang or dangle around the neck at any time.
4. OR scrubs should not be worn in the hospital facility outside of the OR area without a clean lab coat or appropriate cover-up worn over them.
5. OR scrubs should not be worn at any time outside of the hospital perimeter.
6. OR scrubs should be changed at least daily.
7. During invasive procedures, the mouth, nose, and hair (skull and face) should be covered to avoid potential wound contamination. Large sideburns and ponytails should be covered or contained. There is no evidence to suggest that leaving ears, a limited amount of hair at the nape of the neck, or modest sideburns uncovered contributes to wound infections.
8. Earrings and other jewelry worn on the head or neck where they might fall into or contaminate the sterile field should all be removed or appropriately covered during procedures.
The ACS encourages clean, appropriate, professional attire (not scrubs) to be worn during all patient encounters outside of the OR.
The skull cap is symbolic of the surgical profession. The skull cap may be worn when close to the totality of hair is covered by it and when only a limited amount of hair on the nape of the neck or modest sideburns remains uncovered. Like OR scrubs, cloth skull caps should be cleaned and changed daily. Paper skull caps should be disposed of daily and following every dirty or contaminated case. Religious beliefs regarding head wear should be respected without compromising patient safety.
Many different health care providers (surgeons, anesthesiologists, certified registered nurse anesthetists, laboratory technicians, aides, and so on) wear scrubs in the OR setting. The ACS strongly suggests that scrubs should not be worn outside the perimeter of the hospital by any health care provider. To facilitate enforcement of this guideline, the ACS suggests the adoption of distinctive, colored scrub suits for OR personnel.
The ACS emphasizes patient safety and quality of care and prides itself on leadership in an ever-changing and increasingly complex health care environment. As stewards of our profession, we must retain an emphasis on key principles of our culture, including proper attire, since attention to what we wear inside and outside the OR helps to uphold the public’s perception of surgeons as highly trustworthy, attentive, professional, and compassionate.
D.B.L.
2016-10-17
一份声明用词都很谨慎，学习了。谢谢分享。 感谢老师的分享，已经发送给手术室护士长了，学习一下最新的管理理念。 谢谢老师的分享，院感工作无小事，老师好用心，学习了 严格要求很到位，是我们学习的榜样。 谢谢，已经下载收藏，非常感谢老师的资料分享。 很有用的资料，谢谢老师！ 谢谢老师分享，有外科医生正在说要使用全封闭帽子以遮住耳朵，这下有证据了 下载好好的学习，谢谢老师！ 请问老师，手术参观者穿手术衣，里面的衣服是必须全部换成刷手衣还是只用套上手术衣就可以了呢？
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