In the hospital where I work, OR nurses and physicians are frequently seen out and about wearing their scrubs and shoe covers. Is it acceptable for OR personnel to wear scrubs everywhere in the hospital and even home? If so, shouldn't they at least wear a lab coat on top?-N.S., TEX.

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Your facility should have policies and procedures on these issues that are in line with recommendations from the Association of periOperative Registered Nurses (AORN), the Centers for Disease Control and Prevention, and other authorities. Most facilities have a laundry protocol specifying that soiled scrubs be removed and laundered at the hospital. However, some facilities permit staff to wear unsoiled scrubs home.

Under AORN standards, staff members who come to work in scrubs must change into freshly laundered surgical attire whenever entering a restricted or semirestricted surgical area. The use of "cover apparel" such as lab coats depends on the practice setting. The AORN states that the value of cover apparel for reducing contamination is unproven, but facilities may require it for "practical enforcement and cost considerations."

As for shoe covers, these are considered part of personal protective equipment and should be changed "whenever they're torn, wet, or soiled, and they should be removed and discarded in a designated area before leaving the surgical area."

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