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Dirty Scrubs and Other Disease-Spreading Attire

Cheryl Clark, for HealthLeaders Media, January 30, 2014

Old Habits Die Hard


Gonzalo Llorens Bearman, MD

Gonzalo Llorens Bearman, MD
Gonzalo Bearman, MD, lead author of the committee's report spoke with me about how the committee came up with its recommendations, and why. The fact of the matter is that a number of conflicting research papers have come to different and often dizzying conclusions about appropriate healthcare worker attire.

Bearman is a Professor of Medicine and Associate Hospital Epidemiologist at the Virginia Commonwealth University with a focus on infectious diseases, internal medicine, epidemiology, international medical relief and clinical research.

As the committee's report says, old habits, such as the long-sleeved monogramed lab coat, "is steeped in culture and tradition." And old habits do die hard.

"We know that healthcare worker apparel can get colonized with bacteria, whether it's a lab coat or a tie or even a scrub top," Bearman explains. "But there's no slam dunk evidence to prove that colonized apparel results in cross-transmission to cause a hospital-acquired infection. That's the state of knowledge."

"So what we are doing is making some recommendations based on biologic plausibility—what we think is reasonable and feasible, and not difficult to implement."

Bearman stresses that these recommendations are all voluntary, and applicable to all inpatient settings in acute care hospitals except the operating room, which has its own requirements. Here are a few of the committee's recommendations.

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3 comments on "Dirty Scrubs and Other Disease-Spreading Attire"


Alun Jones (2/3/2014 at 9:09 AM)
80% of contamination entering critical environments is done so via feet or wheels. How many hospitals are addressing this by using floor level contamination control solutions such as polymeric flooring?

Bob Hawkins (2/1/2014 at 4:38 PM)
Cheryl, great stuff. Hospitals need to thing of the less obvious places that spread germs, disease and infections. My mother was in an anti contamination room at a Fr. Myers hospital where they took great pains to keep germs away. She went in for a hip fracture and was hampered by infections. I watched every day as a cleaning woman moved the same mop and bucket and dirty water from room to room, swabbing the floors. Only latèr after my mother died there did it occur to me that they might be spreading a germ soup from room to room.. What do you think?

Michael Cylkowski (1/30/2014 at 6:29 PM)
Thanks Cheryl for addressing this issue. It's just as important to not bring those microbes into the community when they wear their scrubs everywhere. Most ORs insist that the clinician change before re-entering the OR, even if they've only been gone a short while. But nobody stops them from walking the streets in their scrubs. I actually saw a cardiologist I know go into a Brookstone Store and lay down on the mattress to try it out - in his dirty scrubs and surgical booties. The store manager called him on it and asked him to leave the store. Several people gave the manager a standing O.