Email Discussion Group

At our facility, all support personnel are required to dress in appropriate surgical attire, which includes scrubs, hats, and masks. Chuck Williams, Cardiac Cath Lab. Emory University Hospital, Atlanta, GA All our staff & MDs wear scrubs & shoe covers. Most MDs and all staff wear hats/caps. Masks are worn by MDs and staff at the table; float staff are optional masks. All personnel are required to wear scrubs (provided by the hospital) in each procedure. However, the only procedures that require a hat, mask, and shoe covers be worn are for pacemaker and ICD implants. During diagnostic caths and interventions, the scrub person wears a hat and mask (shoe covers are optional) while the circulator isn’t required to wear a hat or mask. A couple of our physicians (one is our director) don’t wear hats or masks while at the table. We are a large community hospital in Virginia. Only scrub techs are fully dressed with cap, mask, shoe covers, and, of course, a gown. There is a physician that omits his cap. Otherwise, our circulating RN wears the gear at his/her own discretion. In our lab, the scrub tech and MD wear cap, gown, masks, gloves, etc. The nurse circulating in the room does not wear a hat/cap, gloves or mask. At our hospital, cath lab personnel are required to wear scrubs, hats, and masks for all procedures. All hair, including bangs, has to be covered. We are from a center in S.W. Michigan. Our prep/rec/non-invasive staff also wear scrubs. Yes plus hospital-laundered scrubs. If a long-sleeve t-shirt is worn, then a scrub shirt must be worn over it. Hair must be completely covered. I’m from Liberty, MO. We wear hats and masks during heart caths if the physician does. We are not an interventional lab at this time. About half of our physicians wear hats and masks. Shoe covers are optional. We wear our own scrubs; the hospital discourages wearing hospital-supplied scrubs. Too expensive for the hospital. In our cath lab, all staff entering the room are required to wear hats/caps and shoe covers. The person scrubbing the case is required to wear a mask. If the case is a pacemaker/AICD placement or cardiac biopsy procedure, all staff wear a hat, mask, and shoe covers. Annie Ruppert RN San Diego, CA We only require staff to wear all attire if it is a biopsy or pacemaker patient. The rest of the time, we follow the physicians’ lead (if they do, then we do). Hair cover, mask and shoe covers are required for the scrub tech. The circulator is required to wear hair cover. Kathy Vaughn, Jankcon-Madison County General Hospital, Jackson, TN All staff, including physicians, must wear hats/caps, mask and eye protection. Shoe covers are only if the shoes leave the department. Scott Fylling, Manager of Cardiac Cath/ Special Procedures We all wear hat, cap and mask only if we are doing a pacemaker. The scrub person must always wear a covering of their mouth and eyes, be it a mask and glasses or a full plastic face shield to protect against blood spattering. Bill Colditz, RCIS, Manager, Cardiac Cath Lab, Mercy San Juan Medical Center We wear hats/masks/shoecovers and eye protection in the cath lab when we step to the table. The circulator is not required to wear mask/hat/eye protection. Angela McIntosh-Petrakis, Director, The Outpatient Cath Lab, Baton Rouge, LA Our personnel are required to wear hats/caps in the room when a tray is open. Only the scrub person is required to wear a mask during the procedure. Shoe covers are optional, but everyone does seem to wear them. Doctors are not required to wear hats/caps, mask, and shoe covers, but they are strongly encouraged to. Brian Crosby, Educator/Preceptor, Lee Memorial Health Systems, Fort Myers, FL Seven to eight years ago, we changed our dress code, requiring only the scrub person and physician to wear a hair cover, mask and sterile gown/ gloves. Our infection rate is 0%, as far as I am aware. When there was talk of moving the pacemaker insertions over from surgery to our new lab, we instituted a dress code stating that all personnel in the lab were to be fully covered at all times within the lab. This lasted 3 months, as pacemakers have not been brought over. It would be interesting to see what other labs who also implant pacemakers do. Hospitals that I have canvassed say that they only require masks and caps during the insertion and they do a good cleaning of the room prior to that case. We also allow long-sleeved, mock turtleneck t-shirts under our scrub tops. This remains a controversial topic here! Patti At the present time, our staff are not required to wear caps or shoe covers. We do wear masks of several different types. As for scrub attire, our circulators are not required to wear hats or masks only the scrub tech is. In our lab, everyone wears hats, masks and either shoe covers or dedicated hospital shoes. In addition, we ask everyone to wear eye protection. It is required for those who are scrubbed and HIGHLY encouraged for all others in the room. Natalie D. Beiler Cardiac Cath No, not in the cath lab, unless you are scrubbing. The circulating role and x-ray role do not have to wear hats, masks, and shoe covers. In the EP lab during a pacemaker or device insertion, yes. All staff wear hats/caps, masks and shoe covers are worn by those scrubbing or providing direct patient contact care. Circulators do not wear masks or shoe covers. Sherri DeLashmit, PhD, Director of the Heart Care Center, BMH-NM We perform diagnostic cardiac and peripheral procedures. We also perform interventional peripheral procedures. Caps/hats, masks are required on open or cutdown procedures. Shoe covers are optional. However, face shields/ eyewear, universal precautions and PPDs are required. Steve Gressmire RT(R)(CV) ARRT, Cardiovascular Laboratory Manager, Northwest Mississippi Regional Medical Center, Clarksdale, MS The staff at Stony Brook University Hospital, Stony Brook, NY are required to wear hat/caps and masks. Shoe covers are not required. Mary J. Maliszewski, RN Nurse Manager, Invasive Cardiology & EECP, Stony Brook University Hospital I work at UMC in Las Vegas. Our cath lab personnel that do scrub, wear hat, mask, and shoe covers. The majority of scrub personnel even wear eye protection, be it plain goggles or lead goggles. Occasionally there are a few scrub personnel that do not wear a hat or mask, but there are more physicians who come into the room without shoe covers, mask, or hat. Most physicians are willing to put on protective equipment once reminded, but there is a small percentage who don’t care to wear any. The circulating nurse is not required to wear a mask, but most circulating nurses wear hat covers and mask. Jo Ann Fisher In short, we wear hats & masks when scrubbing; circulating staff wear neither. Shoe covers are worn when wearing shoes that are worn outside the lab. (This being said, most of the time those same shoes go down to the cafeteria, supply dept., etc which defeats the purpose) In my experience in cath labs, most every rule regarding cath lab attire is broken by Drs, reps & other personnel on a daily basis, which begs the question Are these restrictions on cath lab attire redundant? Who do they protect? Personally, I find it strange that traditionally all scrub staff are required to wear hats & masks, when some cardiologists wear neither, and often the patient has no such attire, when they are closer to the sterile field than anyone! I believe in hats to restrain long hair (and not perched on the back of the head, girls...), and masks for scrubs (to protect the scrub from splash injury, and it certainly makes sneezing a little less of a threat!) Let’s collate a set of standards that are practical and appropriate for percutaneous procedures, and not blindly follow theatre standards when we obviously don’t believe in them. Shane, Melbourne, Australia We do require the scrubber and MD to gown, mask and, of course, glove. The circulating nurse in the room is supposed to be gowned or wear PPE (Personal Protective Equipment) during cases. N.J., BSN, RN All staff are required to wear hat, mask, shoe covers and protective eye wear when scrubbing. Hats are required to set up a tray. Staff not scrubbed in are not required to wear PPE unless they come in contact with body fluids. Sheila DeBastiani, RT(R), Supervisor/Educator WakeMed Invasive Cardiology YES…all personnel inside the procedure rooms of the cath lab are required by departmental policy to wear caps/masks/and shoe covers. Our circulator is also required to wear (by OSHA regulation) Personal Protective Equipment (PPE), as is mandated for the scrub tech and physician(s). Jill Lindsey, Cath Lab Manager When scrubbed in for a cath case, the scrub person wears hat, mask and shoe covers, along with lead glasses, while the circulator doesn't have to. If the procedure is a pacer, then all the personnel in the room are required to wear hats, masks and shoe covers. Charlene Houston, Winchester, Va. A couple of our physicians (one is our director) don’t wear a hat or mask while at the table.

Coming in January… The Cath Lab Digest Email Discussion Group responds to the following question:“I’ve just taken this position as a director in the cath lab. I want to start quarterly meetings with cardiologist and my staff at the same time. I'm not sure what certain items or topics that I should be tracking to bring to the table for discussion. Can someone help me with issues that I need to discuss that are discussed at other facilities? I would appreciate it very much. Thanks!” Don Sanders, Dir. CVS, Cullman, AL