Infection and Clinical Attire
The possibility of cross contamination from clothing to wound has been a recent debate.
While a sterile environment is a large part of a healing for a wound, the details surrounding how sterile a clinician’s clothing is has long been debated. Although clinicians are required to maintain a certain level of cleanliness, many travel from home to their workplace wearing their scrubs, exposing their garb to the elements and the public, where certain airborne diseases are more than likely present. So, how large of a role does one’s clothing affect infection rates?
A group of health care professionals from several universities nationwide – including Virginia Commonwealth University, the University of Maryland and Cedars-Sinai Medical Center in Los Angeles, worked to identify how large of an issue fomites and other microorganisms are in a non-operating room environments that many health care professionals know about.
The study, “Healthcare Personnel Attire in Non-Operating Room Settings,” which was published in the journal Infection Control and Hospital Epidemiology, found that most health care individuals do not abide by the GRADE system. A few key points that were noticed include:
- Many clinical professionals who were expected to launder their work attire at home were not following the same washing protocols as health care clinics or hospitals would. For example, some clinicians were not washing their clothes in a hot water cycle, which could leave some pathogens on their clothes that may subsequently come in contact with a patient’s wound or wound site.
- Some clinicians were laundering their lab coats less than once per week. Although this outer layer may not come into physical contact with the patient, airborne bacteria and germs could be present on the coat, especially the longer the duration between cleanings.
- The most common points of contact with a patient were in the hands or lower arms. However, many clinicians do not adopt bare below the elbow, or BBE, policies, and wear things like watches, jewelry and hair ties on these areas. Study researchers have suggested that all clinicians may want to adopt a BBE protocol to limit any cross-contamination between clinician and patient wounds.
Finally, researchers all recommend that further studies are needed to determine the actual concentrations of possible contagions that could be detrimental to the healing process and timelines of patients. For example, one previous study noted that these contaminants, such as Clostridium difficile, can differ based on what shift a clinician is working, so similar niche findings are expected with more in-depth research on the topic.