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Scrub Suits: Sterile Garb or Infection Control Risk?
by Terri Yablonsky Stat
TheSyndicatedNews columnist

Terri Yablonsky Stat is a professional health writer and regular contributor to the Chicago Tribune, AARP The Magazine, Parenting, The Rotarian, North Shore Magazine and many other local and national publications.

The next time you see a healthcare worker wearing scrubs in public, think twice. Sure, they look clean and authoritative, but there’s a health risk to wandering around town wearing this supposedly sterile garb.

And there’s more to consider. What about tools of the trade like stethoscopes, blood pressure cuffs and thermometers that are passed from patient to patient? Can these pose a health threat to the public and patients?

Some healthcare professionals think so.

Retired pediatric heart surgeon Dr. Joseph J. Amato of Rush-Presbyterian-St. Luke’s Medical Center often sees healthcare workers enter and leave the hospital wearing their scrubs. “These articles of wear are only to be worn in operating rooms, intensive care areas, nurseries and other delicate areas of extreme cleanliness,” Amato said. “On a daily basis I see healthcare workers out and about at Walgreen’s or Costco in the early morning and afternoon hours.

“Hospitals say they have strict rules not to leave the hospital with scrubs but that’s not true,” said Amato. “Nobody enforces it. I see stethoscopes wrapped around employees’ necks getting into their cars. They will be used the next morning.” Even ties, he said, can pose a health risk if they’ve had contact with a patient during an exam.

Amato’s not just concerned about the health of children in pediatric intensive care units but the risk of bringing home infections to families.

“If you see people out in public wearing scrubs they may or may not even be healthcare workers,” cautioned Dr. Gary A. Noskin, associate chief medical officer at Northwestern Memorial Hospital and an infectious disease specialist.

There are many reasons people like to wear scrubs, Noskin said. Anyone can buy scrubs through a supplier. Healthcare workers may wear scrubs for convenience and not work in a restricted area of the hospital. For example, some residents wear scrubs while sleeping during long shifts.

“While it is preferable to put on clean scrubs in the hospital, someone who enters the hospital wearing scrubs from the outside poses no risk to patients undergoing surgery because the worker must put on a sterile gown over scrubs,” said Noskin. “There is no evidence that links scrub suits with increased risk for patient infection following surgery.”

Clothes are never sterile, said Noskin. “The single most important way to prevent infection is for health care workers to wash their hands.”

All persons who enter Northwestern Memorial Hospital’s operating room must wear freshly laundered scrubs from its autovalet (automated system for dispensing and retrieving scrubs). Scrubs must be changed when they become visibly soiled. If someone who has left the OR is planning to re-enter, they must don a disposable cover-up. Lab coats should be cleaned regularly.

The same is true at the University of Chicago Medical Center, according to Sylvia Garcia-Houchins, the hospital’s director of infection control. Those who work in the OR must wear hospital-issued freshly laundered scrubs of a certain color and are not allowed to leave the building wearing that scrub. Those who work outside the restricted area cannot wear that colored scrub. The hospital now monitors doors and issues “red tickets” to staff who wear the restricted-area color in from home.

Still, she sees other healthcare workers wearing scrubs in public all the time. “The biggest problem is if you’re wearing your scrubs home after you’ve taken care of patients,” said Garcia-Houchins. “You don’t know if a patient had vancomycin-resistant enterococci, which can live up to seven days on clothing. You can take a patient’s VRE home and hug your child. Respiratory syncytial virus and rotavirus can live on surfaces like a stethoscope or blood pressure cuff and are a big risk to children, too.

“My biggest concern is hand hygiene and cleaning of equipment that moves from patient to patient,” said Garcia-Houchins. “It’s the user’s responsibility to clean items with an alcohol wipe between patients. Patients have to be more aware and more willing to ask the healthcare worker, ‘Did you wash your hands? Did you wash this down before using it on me?’ It’s a new way of life, a new day.”

Published: Aug 28,2008 11:04
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