Does the Joint Commission require employers to launder surgical scrubs or other uniforms?

Any examples are for illustrative purposes only.

NOTE: This FAQ does not apply to any clothing that has been designated by the organization as personal protective equipment (PPE) as defined by Occupational Safety and Health Department (OSHA): specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.)

The Joint Commission standards do not require employers to launder surgical scrubs or other attire.  However, The Joint Commission's Leadership Standard LD.04.01.01 requires health care organizations to adhere to applicable federal (e.g. OSHA), state and local regulations (e.g., licensing requirements), and if deemed, Centers for Medicare and Medicaid Conditions of Participation and/or Conditions of Coverage.   The hierarchical approach to infection control standards as described in The Joint Commission Perspectives, April 2019, should be used to guide development of infection control related policies and procedures for laundering surgical scrubs or attire that is not designated as personal protective equipment and is worn in the healthcare setting. 

Applicable elements to consider include the following:

• The OSHA Bloodborne Pathogen Standard requires that all clothing, including scrubs and personally owned attire such as uniforms or street clothing, which have been visibly soiled with blood or other potentially infectious materials, be laundered by the employer at no cost to the employee.  
• For surgical scrubs, uniforms, or other attire not considered personal protective equipment and which are not visibly contaminated, organizations should determine if there any requirements that the facility provide clean attire to staff to perform their job duties. For example, some states, require that hospitals and ambulatory care facilities provide hospital laundered scrubs for healthcare workers working in the restricted or semi-restricted areas.  State requirements may be more stringent and prescriptive than those from OSHA.
• To our knowledge, Center for Medicare and Medicaid Services (CMS) does not have any requirements for laundering surgical attire or uniforms.  But as recommended by the Joint Commission and CMS, organizations should consult evidence-based guidelines for best practices and consider their adoption.  Examples of guidelines include the Guideline for Surgical Attire (effective July 1, 2019) from the Association for periOperative Nursing (AORN), the AST Guidelines for Best Practices for Laundering Scrub Attire (revised April 14, 2017) from The Association of Surgical Technologists and the Statement on operating room attire (approved July 2016) from the American College of Surgeons.

Additional Resources:

See also the Perspectives®, April 2019, Volume 39, Issue 4 Page 15:  Clarifying Infection Control Policy Requirements