Scrubs should be freshly scrubbed
The next time you see a health-care worker wearing scrubs in public, think twice. Sure, they look clean and authoritative, but you might wonder if there's a health risk to wandering around town wearing this supposedly sterile garb.
And 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 as well as patients?
Some health-care professionals think so.
Retired pediatric heart surgeon Dr. Joseph J. Amato of Rush-Presbyterian-St. Luke's Medical Center often sees health-care workers wearing their scrubs in public.
"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 health-care workers out and about at Walgreens or Costco in the early morning and afternoon hours.
'Nobody enforces it'
"Hospitals say they have strict rules not to leave the hospital with scrubs, but that's not true," said Amato, who lives in Streeterville near Northwestern Memorial Hospital. "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 concerned not just about hospital patients but also about the risk of health-care workers bringing home infections to families.
But Dr. Gary A. Noskin of Northwestern warns against jumping to conclusions.
"If you see people out in public wearing scrubs, they may or may not even be health-care workers," said Noskin, associate chief medical officer at the hospital and an infectious disease expert.
Anyone can buy scrubs through a supplier, he said, and health-care workers may wear scrubs for convenience and not work in a restricted area. 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, he said. "The single most important way to prevent infection is for health-care workers to wash their hands."
Anyone who enter Northwestern's operating room must wear freshly laundered scrubs from its autovalet, an automated system for dispensing scrubs, Noskin said. Scrubs must be changed when they become visibly soiled. People who have left the OR and are planning to re-enter 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.
Endangering the public
Still, Garcia-Houchins sees other health-care 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," she said. "You don't know if a patient had vancomycin-resistant enterococci [a type of drug-resistant bacteria], 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 health-care worker, 'Did you wash your hands? Did you wash this down before using it on me?' " www.chicagotribune.com/features/lifestyle/
~Cyn, McHenry IL
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