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Are scrubs making sick patients sicker?

nurse-scrubsTraditional liquid disinfectants are not EPA approved for use on fabrics or other soft surfaces. The biostatic component in the Nano-Shield two stage system is EPA certified for laundry on its label. Treating fabrics of any kind with Nano-Shield will impart antimicrobial properties for 50 or more launderings. Treating scrubs and other healthcare uniforms not only protects patients but also the families of healthcare workers at home from infectious pathogens.

From Beckers Infection Control and Clinical Quality online newsletter November 12, 2014

Are scrubs making sick patients sicker? How soft surface fabrics spread infection and what to do about it

Written by Staff | November 12, 2014

In a webinar hosted by Becker’s Healthcare on Oct. 14, Peg Luebbert, founder of Healthcare Interventions, discussed how soft surface fabrics in the patient care setting might contribute to the spread of infection.

Soft surface fabrics in the patient environment include scrubs, lab/white coats, privacy curtains and linens. According to Ms. Luebbert, numerous third-party studies have proven fabrics harbor bacteria after coming into contact with patients. One study found that 79 percent of operating room scrubs tested positive for some types of gram-positive cocci and another study showed that 92 percent of privacy curtains showed contamination within one week of being installed.

“These studies show that the strongest and deadliest of bacteria can live for a long time on fabrics,” said Ms. Luebbert. “So it is up to healthcare workers to keep their scrubs and uniforms clean and hygienic. Laundering alone is not the solution because we know the risk of cross contamination exists.”

However, surveys of healthcare workers have shown they launder their hospital garments infrequently. A survey of 160 healthcare providers revealed their white coats were washed every 12 to 13 days and scrubs every 1.7 days. “Also, healthcare workers may not honestly admit how often they wash their uniforms,” said Ms. Luebbert. “They may have only two uniforms and wash them once or twice a week at home or at a laundromat. It’s easy to see how this contributes to the spread of infectious bacteria. However, even with proper laundering, it’s important to remember fabrics are rapidly contaminated when put back in use.”

One of the major issues surrounding the contamination of soft surface fabrics in facilities is the lack of standard guidance or protocols. Regulatory guidelines tend to be outdated and sparse, says Ms. Luebbert. The Society for Healthcare Epidemiology of America has recently taken charge in providing guidance on this issue, however it too admits that lack of evidence has made it difficult to create general recommendations, she notes.

According Ms. Luebbert, internal guidelines in hospitals typically address the issue of attire only in human resource materials. “They talk about how healthcare workers and providers should be neat and hygienically clean,” she said. “But these are loose terms and HR guidelines are the only

place where attire is mentioned. It is rarely talked about from a patient safety standpoint, but rather from an appearance standpoint.”

Healthcare facilities looking to prevent the spread of infection through soft surface fabrics can begin by performing a risk assessment process, such as the SWIFT method, said Ms. Luebbert. This involves evaluating the day-to-day activity of a particular healthcare worker and ascribing ‘what if’ situations to the worker’s routine to identify failures and risks. After conducting the assessment, the facility administrators can come up with plans to improve internal policies surrounding soft surface fabrics, she said.

Healthcare facilities should be looking into the role of antimicrobial fabrics in reducing bacteria load in the healthcare environment. For instance, products powered by X-STATIC technology, a registered antimicrobial with the U.S. Environmental Protection Agency, have been proven efficacious in the bacterial management of soft surfaces. A key benefit of these fabrics is that they don’t require behavior modification by healthcare workers. Other benefits include odor protection and temperature regulation, keeping healthcare workers comfortable during long shifts, said Ms. Luebbert.

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