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Research conducted on nursing and physician uniforms noted that bacterial counts on uniforms are higher at the end of the work shift , suggesting bacteria are spread through patient contact .
nation at home , community , and perioperative environment . The facility or commercially laundered scrub attire should be donned by all surgery personnel prior to entering a semi-restricted or restricted area of the surgery department .
• Clean , freshly laundered scrub attire should be protected from contamination when transported from the HDO laundry or commercial laundry facility to the storage area .
• The surgery department should review the policies and procedures regarding handling and laundering soiled scrub attire on an annual basis .
• Certified scrub techs should complete continuing education to remain current in their knowledge of handling and laundering soiled scrub attire .
As Vera , et al . ( 2016 ) acknowledge , “ Establishing a relationship between contaminated scrubs and SSI incidence is difficult because of the vast causes of SSI . Moreover , the risk is dependent on the number and type of microbes , as well as resistance of the host . It is acknowledged that uniforms worn by healthcare workers become contaminated with microorganisms during patient care , notably during surgical procedures . It is logical to infer that SSIs may result from microbes present on scrubs worn by OR personnel . Given the importance of establishing the cleanest surgical conditions for the prevention of SSI , the proper laundering of scrubs is a major issue for staff .”
The researchers add , “ It has been identified that up to 60 percent of healthcare personnel ’ s uniforms may be contaminated with microorganisms . A myriad of publications emphasizes the bacteria-carrying ability of hospital uniforms throughout workday activities . Research conducted on nursing and physician uniforms noted that bacterial counts on uniforms are higher at the end of the work shift , suggesting bacteria are spread through patient contact … The presence of pathogens and potential for vehicular transmission via scrub uniforms has been identified in both small-scale studies and randomized controlled trials . Whether this is clinically significant depends on whether scrubs are found to be pathogenic in environments where extreme cleanliness is imperative , such as the OR .”
They continue , “ There is some evidence that ineffective washing of facility-laundered surgical scrubs ( FLSS ) is linked with SSIs . One case report describes a microbial link between scrubs contaminated with large amounts of Bacillus cereus during prolonged neurologic surgery time , resulting in meningitis for two postoperative patients . It was later discovered that the infection was the result of improperly washed contaminated facility laundry rather than surgical time and exposure of scrubs to the wound site .”
The literature notes that scrubs improperly decontaminated in the home setting may be linked to SSI . For example , a polymicrobial outbreak in patients who had undergone cardiac surgery is affirmed in one report , which cited microbial contamination in 14 of 22 postsurgical patients . Involved staff members ’ wearing
of scrubs and uniform jackets that had been home-laundered was reported as a strong correlate .
In a nonexperimental study of OR surgical attire conducted as the result of an increase in multidrug-resistant organisms and HAIs , Nordstrom , et al . ( 2012 ) took swatches from unwashed , hospital-laundered , home-laundered , new cloth , and disposable scrub attire and tested them for the presence of microorganisms . The researchers found that the home-laundered scrub attire had a significantly higher total bacterial count than the facility-laundered attire , and they found no significant difference in bacterial counts between hospital-laundered , unused , or disposable scrub attire . The researchers concluded that although it is not known how contaminated scrub attire contributes to the spread of HAIs , hospital administrators and infection preventionists need to consider the potential for transmission of infection versus cost savings to the facility if home laundering is allowed . The researchers advised that health care workers be made aware of the risks of home laundering and be provided with instructions for best methods for home laundering in order to reduce the risk of infection .
Vera , et al . ( 2016 ) articulate the differences between FLSS and domestic laundering : “ Facility laundering is the decontamination of textiles at accredited facilities following industry standards … Facility laundering typically uses a continuous-batch washing machine that decontaminates the items in the wash load at a minimum of 65 degrees C for a minimum of 10 minutes , but more commonly at a temperature of 71 degrees C for 3 minutes using bleach for grossly contaminated items . In comparison , home laundering is the process of laundering uniforms in the home setting using a domestic home washing machine and dryer . Domestic washing machines typically operate at temperatures of 60 degrees C for 30- to 40-minute cycles but can reach higher wash temperatures of 90 degrees C . Newer domestic washing machines using the Energy Star technology consume 37 percent less energy and 50 percent less water than their counterparts . The trend toward lower temperature and water consumption and lack of regulation over home laundering has incited theoretical concerns of uniforms being ineffectively decontaminated in the home . Laundering of scrub uniforms at 71 degrees C , per CDC recommendations , is not achievable using most home washing and evidence suggests that bacterial eradication from clothing is less effective using lower temperatures .”
These researchers point to what they believe is a draw in the debate between industrial laundering and domestic laundering : “ Evidence comparing facility and home laundering of surgical scrubs in SSI prevention is lacking . The only study comparing these methods has concluded no difference exists in efficacy . The perceived advantage of regulatory bodies overseeing laundering facilities should be carefully stated because microbial testing is not a standard in facility-laundered textiles ; thus , continual levels of contamination are not assessed . Finally , there is no compelling