How to get a thermal vest approved for use in the OR or clinical areas
To get a thermal vest approved for the OR or other clinical areas, start with your facility's written attire policy. Then take a short, documented request to the people who own each question: infection prevention for fabric and laundering, perioperative leadership for where it may be worn, value analysis for unit purchases, and biomedical or safety staff for anything with a battery.
Can you wear a thermal vest in the OR?
Sometimes, and only on your facility's terms. There is no national list of approved warm layers. AORN's 2024 summary of its surgical attire guidance says an interdisciplinary team should decide what fabrics may be worn, how much may extend beyond the surgical attire, and how often and by what method it is laundered.
Facilities land in different places. One published hospital policy, from Geisinger, requires warm-up jackets to be buttoned or snapped closed and disposed of daily, allows plain short-sleeve tee shirts only if covered by scrub attire, and does not permit home laundering. It does not mention vests at all, which is common. A policy that is silent on vests is a reason to ask, not a yes.
Step 1: What should you look for in your attire policy?
Find the current written policy, usually on the intranet or through your perioperative educator, before you buy anything. Note the exact wording; your request will quote it.
Personal clothing under scrubs: allowed, allowed if fully covered, or not allowed
Cover and warm-up jackets: facility-issued only, disposable, or personal
Laundering: facility or accredited laundry only, or home washing permitted
Areas: whether rules differ for restricted, semi-restricted and unrestricted areas
Fabric: any requirement for low-linting or tightly woven material
Electronics and personal items: cleaning rules and any limits on devices
Step 2: What does professional guidance say about attire and cover jackets?
Approvers will weigh your request against professional guidance, so it helps to know the headlines. AORN describes surgical attire as including a long-sleeve scrub jacket, also called a warm-up jacket, worn in semi-restricted and restricted areas. It asks that personal handheld electronics be cleaned and disinfected before entering the OR, with frequent hand hygiene when handling them.
The American Society of Anesthesiologists' Statement on Surgical Attire, last amended in 2022, recommends clean scrub attire that fits well and a process for laundering scrubs regularly and whenever visibly soiled. It says local attire policy should be developed by multidisciplinary teams and should balance infection control with the strength of evidence, feasibility, and environmental and economic burden.
Neither body approves or rejects specific garments. Do not describe any vest as AORN compliant; describe how it meets your facility's policy.
Step 3: Who decides, and what does each approver need?
AORN names perioperative nurses, surgeons, anesthesia professionals, infection preventionists and others chosen by the organization as members of the team that sets attire policy. In practice, different people own different parts of your question. Titles vary, so ask your manager who handles each one.
| Question | Usually owned by | What they want to see |
|---|---|---|
| Is the fabric and laundering acceptable? | Infection prevention | Fiber content, weave, care label, laundering plan |
| Where and when may it be worn? | Perioperative leadership or unit manager | Areas, coverage under scrubs, workflow impact |
| Should the unit buy or stock it? | Value analysis committee or supply chain | Specifications, related policies, evidence, pricing |
| Is the battery or electrical part safe? | Biomedical or clinical engineering, safety office | Battery type, watt-hours, certifications, charger |
| Is a warming insert used safely? | Infection prevention and unit leadership | Maker's instructions, skin-contact warnings |
Step 4: What documentation should you bring?
Healthcare Hygiene magazine, describing Premier's value analysis approach, lists product specifications, associated policies and procedures, evidence-based literature and supplier pricing among the inputs committees use. For a single personal garment you need less, but the same logic applies.
Fiber content and fabric construction, from the sewn-in label or spec sheet
The care label and your laundering plan, matched to the policy wording
A spec sheet or product page, plus a photo of the vest worn under your scrub top
For any battery: chemistry, voltage, watt-hours, the charger, and whether it is tested to a standard such as UL 62133-2 or UL 2054
For warming inserts: the maker's instructions, including any warning against direct skin contact
A search of the CPSC recall database for the brand and model
Step 5: How should you word the request?
Keep it short and specific. A workable note reads like this: I work day shift in the main OR and the rooms stay cold enough that I am uncomfortable during long cases. I would like to wear a thin vest fully under my scrub top in the semi-restricted and restricted areas. It is a tightly woven polyester shell with no battery. I will launder it according to policy, or keep it at the facility if that is required, and I will remove it if it becomes soiled. I have attached the fiber and care labels, the spec sheet and a photo. If this is not acceptable, could you tell me which warm layers are approved?
Send it to your manager and ask them to route it. UL notes that UL 2054 has been added to OSHA's Nationally Recognized Testing Laboratory program list for battery safety in portable and wearable devices, so if your vest has a battery, name the standard and the lab. NFPA advises using certified devices and the charger designed for them.
What if the answer is no, or only partly yes?
A partial yes is common: allowed in semi-restricted areas but not during procedures, or allowed if facility-laundered. Ask what would change the answer and when the policy is next reviewed.
If the vest is declined, ask for the approved alternative, such as a facility warm-up jacket, and raise room temperature concerns through your manager. If cold on shift comes with color changes, numbness or pain in your fingers, talk to a clinician about those symptoms.
Where HEATJAC fits
HEATJAC CORE, designed by an anesthesiologist, is a low-profile thermal harness platform with integrated heat-reflective thermal inserts and pockets that accept supplemental warming elements such as air-activated warmers (sold separately). It has no built-in battery, so a request for it centers on the attire and laundering questions above, while any warming element you add is a separate item to disclose. Like any garment, it is approved for a unit only when that facility says so.
Key takeaways
No vest is approved for the OR until your facility says so; a silent policy means ask.
Read the written attire policy first and quote it in your request.
Route each question to its owner: infection prevention, perioperative leadership, value analysis, biomedical or safety.
Bring fiber content, the care label, a laundering plan, a spec sheet and any battery certifications.
Ask for the approved alternative if the answer is no.
Frequently asked questions
Can I wear a fleece or vest under my scrubs in the OR?
It depends on your facility. AORN leaves personal clothing under scrubs to an interdisciplinary team that sets fabric and laundering rules, and fleece can shed lint, which infection prevention teams weigh. Read your policy and ask before wearing it.
Who approves clothing in the operating room?
The attire policy is usually owned by perioperative leadership with infection prevention, and AORN recommends a team that includes nurses, surgeons, anesthesia professionals and infection preventionists. Your unit manager can tell you who reviews individual requests.
Does a heated vest need extra approval in the OR?
Usually yes. Anything with a battery or controller may need review by biomedical engineering or the safety office, in addition to the attire questions. Bring the battery's watt-hours, charger details and any certification.
Is any thermal vest AORN approved?
AORN publishes guidelines, not product approvals. Be wary of any listing that claims a garment is AORN approved; what matters is whether it meets your facility's written policy.
Can I wash an OR vest at home?
Only if your policy allows home laundering. Some facilities require facility or accredited laundering and do not permit home washing at all. Ask what happens if the vest becomes soiled during a shift.
Related reading
Sources
Surgical Attire, Stethoscopes and Personal Items, Association of periOperative Registered Nurses (AORN)
Statement on Surgical Attire, American Society of Anesthesiologists
Clinicians and Value Analysis Professionals Can Drive Product Evaluation Within the Framework of Quality and Safety, Healthcare Hygiene magazine
Understanding Portable Battery Safety: the UL 62133 family of standards, UL Solutions
Lithium-Ion Battery Safety, National Fire Protection Association
About HEATJAC. HEATJAC is a thermal architecture company founded by an anesthesiologist. We design patented garment systems that capture, conduct and broaden warmth across the body, and we publish this knowledge hub because the science of staying warm should be public. HEATJAC products are not medical devices and are not intended to diagnose, treat, cure or prevent any disease.