If the possibility exists that microorganisms could be transferred to family members , community members , patients , and other HCP , as well as place the person wearing the scrub attire at risk due to the ineffectiveness of home-laundering , then HCP have the ethical and moral duty to take the proper steps in preventing that possibility from occurring .”
scrubs . Conversely , AORN opines that after daily use , reusable surgical attire should be laundered in a facility-approved laundry . Furthermore , OSHA states that employers are required to launder employee-owned scrubs that have become visibly contaminated during work and concludes that scrubs not soiled with blood or virulent matter may be laundered at home . When developing a surgical scrub policy , policymakers would be prudent to use the available evidence to establish a guideline for scrub uniform decontamination . Because of varying perceptions and lack of definitive evidence supporting one laundering method over another , data elicited in these studies would best be regarded in an equitable manner when one is establishing and enforcing a facility uniform policy . It is reasonable to allow for self-laundering of scrub uniforms by staff if they follow standard recommendations for employing a proper decontamination process at home . To ensure proper decontamination of scrubs , specific guidance should be provided for a home-laundering program to include recommendations derived from available research . Studies show that home laundering in temperatures between 40 degrees C and 60 degrees C is equally effective at decontaminating garments if proper decontamination measures are undertaken .”
In an October 2020 FAQ , The Joint Commission clarified issues around whether it requires employers to launder surgical scrubs or other uniforms . It emphasized that requirements do not apply to any attire that has been designated by the organization as personal protective equipment ( PPE ) as defined by Occupational Safety and Health Department ( OSHA ): specialized clothing or equipment worn by an employee for protection against a hazard . General work clothes ( e . g ., uniforms , pants , shirts or blouses ) not intended to function as protection against a hazard are not considered to be personal protective equipment .)
Joint Commission standards do not require employers to launder surgical scrubs or other attire ; however , its Leadership Standard LD . 04.01.01 requires healthcare organizations to adhere to applicable federal ( OSHA ), state and local regulations ( licensing requirements ), and if deemed , Centers for Medicare and Medicaid ( CMS ) Conditions of Participation and / or Conditions of Coverage . The Joint Commission ( 2019 ) indicates that the hierarchical approach to infection control standards should be used to guide development of infection control related policies and procedures for laundering surgical scrubs or attire that is not designated as PPE and is worn in the healthcare setting .
The Joint Commission ( 2020 ) says the applicable elements to consider include the following :
• The OSHA Bloodborne Pathogen Standard requires that all clothing , including scrubs and personally owned attire such as uniforms or street clothing , which have been visibly soiled with blood or other potentially infectious materials , be laundered by the employer at no cost to the employee .
• For surgical scrubs , uniforms , or other attire not considered personal protective equipment and which are not visibly contaminated , organizations should determine if there any requirements that the facility provide clean attire to staff to perform their job duties . For example , some states require that hospitals and ambulatory-care facilities provide hospital-laundered scrubs for healthcare workers working in the restricted or semi-restricted areas . State requirements may be more stringent and prescriptive than those from OSHA .
As The Joint Commission ( 2020 ) notes , “ To our knowledge , CMS does not have any requirements for laundering surgical attire or uniforms . But as recommended by The Joint Commission and CMS , organizations should consult evidence-based guidelines for best practices and consider their adoption . Examples of guidelines include the Guideline for Surgical Attire from the Association of periOperative Registered Nurses ( AORN ), the AST Guidelines for Best Practices for Laundering Scrub Attire from the Association of Surgical Technologists and the statement on operating room attire from the American College of Surgeons .”
It is important to distinguish the locations in which healthcare attire is worn , as more stringent policies tend to be applied toward surgical attire to prevent surgical site infections ( SSIs ).
Attire in Surgical Services
The Association of Surgical Technologists ( AST )’ s Guidelines for Best Practices for Laundering Scrub Attire ( 2017 ) note that , “… Most of the evidence in studies establish that home-laundering is ineffective for removing microorganisms from scrub attire and thus , the possibility exists that patients , healthcare personnel ( HCP ), and the community is at-risk for developing life-threatening infections when scrub attire is home laundered . Additionally , biofilms can form inside washing machines and the biofilm containing the microbes introduced into the washing machine by used scrub attire are more resistant to chemicals and temperatures .” AST ( 2017 ) adds , “ If the possibility exists that microorganisms could be transferred to family members , community members , patients , and other HCP , as well as place the person wearing the scrub attire at risk due to the ineffectiveness of home-laundering , then HCP have the ethical and moral duty to take the proper steps in preventing that possibility from occurring . Patients place their trust in HCP to provide the safest care possible daily and supporting home-laundering violates that trust .”
This view is supported by those expressed in a report from the National Institute for Occupational Safety and Health ( NIOSH ). The Report to Congress on Workers ’ Home Contamination Study Conducted Under the Workers ’ Family Protection Act states that , “ Infectious agents are included as hazardous substances to the extent that pathogens can be transported on a worker ’ s person or clothing ,” and that home laundering of contaminated clothing exposes the launderer and others in the household to potential pathogens . Additionally , the report noted “ the possibility appears to exist for bloodborne diseases such as HIV or HBV to be transported home on a worker ’ s clothing soiled with body fluids from an infected person .” AST ( 2017 ) makes the following recommendations :
• Scrub attire should be laundered in an accredited HDO or commercial laundry facility to reduce the risk of cross-contami-