Lead Apron Safety Requires Collaboration Across Infection Prevention, OR, and Radiology Teams

Preventing surgical site infections (SSIs) requires more than following sterile technique. It also depends on identifying overlooked risks that can introduce contamination into the operating room. During a recent panel discussion hosted by Infection Control Today^® along with Diagnostic Imaging^®, infection preventionists (IPs), perioperative leaders, and industry experts agreed that contaminated lead aprons and thyroid collars deserve far greater attention. Their message was clear: solving the problem requires collaboration, not finger-pointing.

Brenna Doran, PhD, MA, ACC, CIC, AL-CIP, an IP, explained that the issue first came to light through the strong relationship her team had built with the operating room staff.

"We identified our lead because of the relationship that we had cultivated with our [operating room (OR)] team," Doran said. "There wasn't enough space to hang the lead, and the lead was on the ground. So how do we solve this opportunity?"

Rather than approaching the problem from a adherence standpoint alone, Doran emphasized the importance of understanding operational realities.

"IPs look at their roles as the opportunity to blend best practices with reality," she said. "We need your operational expertise. We need to understand your barriers and limiting factors in order to co-create solutions. My expertise is meaningless without your input."

Justin McKay, cofounder of RadCare Services, echoed that philosophy, describing his role as a partner rather than someone dictating policy.

"I'm in your corner," McKay said. "You're driving the motorcycle. I'm riding in the sidecar."

Over the past decade, he explained, the conversation has evolved beyond simply cleaning lead garments.

"We've evolved into a true management partner," McKay said. "We'll talk about storage racks, proper storage, scheduled deep cleaning, inspections between cleanings, and garment fit. People best support what they help to create, so present options and let teams build the process together."

Peter Graves, BSN, RN, CNOR, an operating room leader, admitted that lead apron management is often overshadowed by countless competing priorities but believes it deserves a much higher profile.

"If it's not on your radar, it should be," Graves said. "We have to do better."

He encouraged perioperative leaders to treat lead garments like any other piece of protective equipment.

"Make sure your staff is cleaning. Make sure your staff is inspecting. Make sure your lead is hung up correctly," Graves said. "Everything is supposed to be clean, and if it's not, we have to do better."

Looking ahead, Doran challenged the infection prevention community to generate stronger scientific evidence linking contaminated lead garments to healthcare-associated infections.

"I would really love somebody to do cultures and PCR and see if we can make an epidemiologic link between some of our [methicillin-resistant Staphylococcus aureus] or Staphylococcus aureus surgical site infections and lead aprons," she said.

She also called for a practical playbook that infection preventionists could adapt within their own facilities.

"It's so much easier to do something that someone else has done successfully than it is to create the wheel on our own," Doran said.

Panelists agreed that any future guidance should extend beyond the operating room. Graves recommended involving radiology, interventional radiology, emergency departments, and other procedural areas to develop standardized protocols across the health system.

For McKay, the discussion reinforced the importance of relationships.

"Relationships are everything," he said. "There are resources. There are data. We can work together collaboratively to drive change and do no harm."

The panel concluded that improving lead apron management is less about assigning responsibility than creating partnerships. By bringing together infection preventionists, perioperative teams, radiology, sterile processing, and hospital leadership, health care organizations can develop sustainable programs that reduce contamination risks and strengthen patient safety.