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Dirty Scrubs and Other Disease-Spreading Attire

Cheryl Clark, for HealthLeaders Media, January 30, 2014

1. Bare below the elbows, or BBE
This means short sleeves, no wristwatches, no jewelry and no ties during clinical practice. One important reason for this policy is to encourage providers to wash their hands to the wrists between patient encounters.

"What we try to do is decrease the bioburden at the point of care in the inpatient setting," Bearman says. "So by not wearing a long sleeve, not having a cuff, not having a wristwatch on or wrist jewelry, it's much easier to do hand hygiene that's effective to at least the level of the wrist or midforearm."

2. White Coats
Each provider should have two or more, and should have a convenient and economical way to launder these coats. Asked if hospitals should be encouraged to launder those coats to avoid home laundering at potentially insufficiently high temperatures, Bearman says "there's no real data to suggest where it should be laundered. In theory, if you have an industrial laundry in the hospital that uses high temperature washes and puts things in a drier at high temperature, that should probably eradicate all bacteria and spores, and in theory that would be superior, and a boon, but there nothing to support that in the literature.

A hospital laundry service would eliminate the possibility that providers would wear scrubs or other attire in their communities, where they could be potentially infected, only to return to the hospital with those same pathogens. Clinicians could simply put on their clinical garb after they arrive at the hospital, and take it off before they leave. That too makes sense, Bearman says, but there's no evidence to date that it prevents hospital-acquired infections.

Clothing that comes into contact with the patient or a patient's environment should be laundered after daily use, the guideline suggests. But white coats should be laundered "no less frequently than once a week and when visibly soiled."

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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.