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Dirty Scrubs and Other Disease-Spreading Attire

Cheryl Clark, for HealthLeaders Media, January 30, 2014

3. Coat Hooks
The SHEA guidelines call for organizations to provide coat hooks where white coats and other long-sleeved outerwear can be placed prior to patient contact.


Andrew Shulman, MD, PhD

Andrew Shulman, MD, PhD

This would mean that during rounds, clinicians would be spending a lot of time taking their coats off and putting them back on again. And what if two or more clinicians need to see the patient at the same time? Who gets to use the hook?

4. Neckties
The committee did not find enough evidence to tell healthcare providers they can't wear neckties, saying their role in transmission "remains undetermined." Bearman explains that studies have shown that neckties can become colonized with pathogens, and there's "biologic plausibility that neckties could dangle on patients, devices, wounds or skin and potentially cross transmit a pathogen," there's no evidence that it has.

Just to be on the safe side, however, especially since ties are rarely if ever washed in hot water (unless by mistake), clinicians should avoid neckties. But if they feel they must wear them, "at the very least fasten it so that it doesn't dip into or come into direct contact with a patient. You could have a coat or vest that holds it back, or a tie clip, or you could simply have a button in your dress shirt and tuck the tie in."

Another idea: Wear a bow tie. Andrew Shulman, MD, PhD, a pediatric rheumatologist on Orange County, CA, is a bow tie wearer and advocate who has written about why he wears them. (He was not involved with the SHEA study.)

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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.