9.23.2008

on the old white coat

I once worked with a charge nurse who never wore her scrubs home. When I asked her why, she said that she didn't want to bring whatever germs she encountered home to her family. Despite the fact that she was the infection control nurse for the hospital, I thought it was a shame that she didn't share this insight with the rest of the hospital.

Surgical nurses and doctors never wear their scrubs from home to work, but most of the nurses in the ER wear their stuff to work and home again. What role does clothing play in the transmission of disease? From Today's New York Times:

Amid growing concerns about hospital infections and a rise in
drug-resistant bacteria, the attire of doctors, nurses and other health
care workers — worn both inside and outside the hospital — is getting
more attention. While infection control experts have published
extensive research on the benefits of hand washing and equipment
sterilization in hospitals, little is known about the role that ties,
white coats, long sleeves and soiled scrubs play in the spread of
bacteria.


The discussion was reignited this year when the British National
Health Service imposed a “bare below the elbows” rule barring doctors
from wearing ties and long sleeves, both of which are known to
accumulate germs as doctors move from patient to patient.

....

Another study at a Connecticut hospital sought to gauge the role
that clothing plays in the spread of methicillin-resistant
Staphylococcus aureus, or MRSA.
The study found that if a worker entered a room where the patient had
MRSA, the bacteria would end up on the worker’s clothes about 70
percent of the time, even if the person never actually touched the
patient.

“We know it can live for long periods of time on
fabrics,” said Marcia Patrick, an infection control expert in Tacoma,
Wash., and co-author of the Association of Professionals in Infection
Control and Epidemiology guidelines for eliminating MRSA in hospitals.

Hospital
rules typically encourage workers to change out of soiled scrubs before
leaving, but infection control experts say enforcement can be lax.
Doctors and nurses can often be seen wearing scrubs on subways and in
grocery stores.

Personally, I don't change out of my clothes at work, but I probably should. I can say I don't let anyone touch me when I come home until I'm out of my scrubs. (My girls know I have a no hugs policy until I'm in my comfy clothes.) After this article, however, I might need to be a bit more aggressive about keeping the hospital germs in the hospital and out of the community.

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