ID Experts Issue Recommendations on Healthcare Attire — Physician’s First Watch

Medical News |
January 22, 2014

ID Experts Issue Recommendations on Healthcare Attire

By Amy Orciari Herman

The Society for Healthcare Epidemiology of America has issued new guidelines to help prevent infection transmission through healthcare personnel attire outside the operating room. The group acknowledges that the role of clothing in cross-transmission remains "poorly established."

Among the recommendations, published in Infection Control and Hospital Epidemiology:

  • A bare-below-the-elbows strategy may be considered for inpatient settings to supplement traditional infection-control measures.

  • If white coats are mandatory, clinicians should have more than one available, and hooks should be provided so that coats can be removed before patient contact.

  • All apparel that comes in contact with the patient or patient environment should be washed after daily use; a hot water cycle, followed by a dryer cycle or ironing, can kill bacteria.

Reader Comments (9)

Deborah Lauman ARNP Other Healthcare Professional, Internal Medicine, Private Practice and Academia

I disagree that all the suggestions are not practical. It takes common sense and knowledge on infection control. One topic that I would like to bring up is the importance of washing our hands prior and after patient contact. Also, for all of you that insist on placing the stethoscope around the neck when not in use. Think otherwise, this is a great way to transfer microorganisms. Don't wear street clothes to practice, unless you are prepared to wash them daily. By the way, how many of us takes off our work clothes as we walk into our homes? Maybe we should, what do you think?

JACK MOSS Other, Emergency Medicine, home office

agree, but suggest bleach, a great antibacterial/antiviral be added to the wash

Caliann T. Lum, MD, PhD Physician, Office - HIT

Regarding item 2 - is there no concern that physicians seeing patients in street clothes will then carry hospital/resistant organisms back into their own homes and community? And how is it different to visit patients in the same street clothes, one after the other, versus in a white coat that at least stays (one hopes) at the hospital, and can be cleaned or exchanged for clean versions daily, as an automated hospital service? Or consider having cover gowns outside each patient's room for clinician use, with these being changed/laundered daily. Then, at least, each patient will only be exposed to their own organisms.

Steve Sammuel,MD/PhD Physician, Obstetrics/Gynecology, Georgia Allied Group

All these rules and more are very nessesary to adhere. Most importantly do not wear your scrub to lunch after being in a patients environment and back to patients again. Also good hand washing technics should be adhered to.

Robert Nasser, MD Physician, Ophthalmology, Office/teach at Med School

Add to above, "Scrubs" are not to be worn out of the hospital…or worn home. Not only does that encouage the spread of bacteria from Hospital to community, there is a real danger of brining contamination into the patient care area.

Laura H. Kahn, MD, MPH, MPP Physician, Internal Medicine, Academia

All health care personnel should wear only short, unadorned fingernails. Long fingernails, false fingernails, and fingernail polish should be prohibited. I am always shocked at seeing female physicians and nurses wearing inappropriately long nails at work. During training, we were sent home and not allowed to return until our nails passed inspection. In an era of worsening antimicrobial resistance, we need to return to enforcing these strict mandates.

James Irwin Physician, Family Medicine/General Practice, Jerome Idaho

Rings also appear to be a real issue

Jose L. Calderon, MD Physician, Family Medicine/General Practice

Consideration may also be given to the role of neckties. I've always had concerns in the hospital about leaning over and my neckties coming in contact with patient clothing, bedsheets, etc. Clip on ties that may be easily taken off and put in ones pocket is an alternative but allowing neckties to be taken off during rounds in programs and hospitals that require them may be considered. I favored the use of surgical scrubs that are put in the laundry bin after rounds and allowed me to change into my 'work' clothes that remain uncontaminated.

J.Ostroski, M.D., F.A.C.S. Physician, Surgery, Specialized, Large community Hospital

The society is correct only in one aspect "the role of clothing etc is poorly established". All of the suggestions are impractical, they ought to be concentrating on runny nose/coughing, rigid hand washing issues especially when there is actual patient contact , i.e.wound inspection, auscultation , and then one might suggest appropriate gown and glove techniques. I wonder if any of this committee actually practice medicine in Hosp or otherwise.

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