Go Back

Head covering change coming soon to all restricted areas

13 Aug 2021

By: Denise Hoover, Vice President, Surgical Services

You will soon see a supply change in all restricted areas that will swap out the traditional, tie-back surgeon’s skull cap for a longer-line cap that covers the back of the head completely and without an opening.

This change is prompted by the regulatory requirement from the Centers for Medicare and Medicaid Services (CMS) that “all hair” is covered while in the restricted areas including ORs, cath labs, and procedure rooms. The traditional surgeon skull cap ends just above the ears, leaving too much hair exposed on the back of the head (see image A). The replacement product covers further down to contain the rest of the hair (see Image B).

unapproved head covering         approved head covering
Unacceptable head covering in image A (left), with hair showing; approved head covering in image B (right).

While the American College of Surgeons and the Association of periOperative Registered Nurses have determined that the type of head covering worn does not seem to affect patient outcomes, the CMS regulation remains clear and a citation for failure to comply could result in a significant deficiency meriting a follow-up survey.

Cloth caps remain acceptable, but also must cover all hair (e.g. cannot be too short or gap in the back) and be freshly laundered daily. Any caps that do not meet those guidelines will need to be covered by a disposable cap.

Should CMS guidelines change, we will absolutely re-evaluate our product options! We are seeking a commercially produced cloth cap as well that would meet these criteria, but have not yet found one that our testers have approved. 

We will be auditing and reminding all team members in the restricted areas of this requirement, so please help us by making this switch. Questions and comments can be directed to Deni Hoover and Dr. Angela Anderson in Surgical Services.