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Based on observation, interview and policy review, the facility did not provide services in accordance with acceptable standards of practice and the facility's policy regarding surgical attire which potentially placed patients at risk.

Findings:

Observation in operating room #1 on 5/19/15 at 10:30AM revealed a robotic hysterectomy in progress. During the surgery, Staff # 31, 32, and 33 were observed wearing a "skull cap" type of head covering with exposed hair in back of the head and along the ears.

Review on 5/19/15 of policy "Surgical Attire", last revised 3/19/15 indicated that all head and facial hair is to be covered while in the restricted and semi-restricted areas.

During interview with Staff #2 on 5/19/15 it was verified that exposed scalp hair was visible on Staff # 31, 32 and 33 during a surgical procedure in the operating room.

Failing to assure that proper surgical attire is worn in the operating room places patients at risk for infection or other surgical complication.