Donning of scrubs on entering ICU

[Anonymous]

I’m wanting to know of any hospitals with a policy that requires all staff to change into ‘scrubs’ via a dedicated change room prior to entering the intensive care unit, similar to how theatre staff change into ‘scrubs’ prior to entering an operating theatre? If so, is the policy supported by evidence.

Many thanks

Matthew Richards
Clinical Nurse Consultant
Infection Prevention and Surveillance Service
Melbourne Health
T: 9342 8325 F: 9342 8484 E: matthew.richards@mh.org.au

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

[Matthias Maiwald (KKH)]

Matthew,

This depends what kind of evidence you are looking for, and what the evidence is supposed to be for. For the change into scrub suits before entering the ICU, or for using a dedicated change room?

Much of the evidence in terms of various clothing requirements in various hospital areas is historical evidence and derived from microbiological data and from what makes biological sense in terms of pathogen transmission. That branch of research goes back to about the 1950s or 1960s, although several professional bodies have their recommendations, and there are newer pieces, e.g.:

http://www.ncbi.nlm.nih.gov/pubmed/17828691

http://www.ncbi.nlm.nih.gov/pubmed/3529043

You won’t find any randomised clinical trials in that area (if so, I would be surprised).

The microbiological rationale and biological plausibility for dedicated clothing for certain areas comes from the fact that when freshly-laundered clothing is put on, this clothing acquires the wearer’s (and to a lesser extent the environment’s) microorganisms, and this bacterial burden increases over the time of wearing. This is thought to be similar for street clothing and scrubs, and what happens is that over time the wearer disperses these microorganisms into the environment around her or him, although this also depends on how tightly woven the garments are (scrubs are more tightly woven, so lesser shedding). This is called the “cloud phenomenon”. The acquisition and dispersal of microorganisms includes pathogens like Staph. aureus in those who are colonised. That means, what the wearing of fresh scrubs effectively does is it sets the “clock” of microorganism acquisition and dispersal effectively back to zero each time a new suit is put on. The issue is that if institutional scrub-wearing is set up, and the change into fresh scrubs is mandated, the institution has some control over this microorganism acquisition and dispersal, whereas if people can wear street clothes or re-use old scrubs, then there is no institutional control over this biological process. (People may come in with several-days-old street clothing if the process is not controlled).

What the change rooms effectively do is to provide convenience and uniformity in the sense of having an area where to change and providing a stocked supply of fresh scrubs.

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

—–Original Message—–

I’m wanting to know of any hospitals with a policy that requires all staff to change into ‘scrubs’ via a dedicated change room prior to entering the intensive care unit, similar to how theatre staff change into ‘scrubs’ prior to entering an operating theatre? If so, is the policy supported by evidence.

Many thanks

Matthew Richards
Clinical Nurse Consultant
Infection Prevention and Surveillance Service Melbourne Health
T: 9342 8325 F: 9342 8484 E: matthew.richards@mh.org.au

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

———————————————————————————
The information contained in this e-mail and the attachments (if any) may be privileged and confidential and is intended solely for the named addressee. If you are not the intended recipient, please do not print, retain copy, disseminate, distribute, or use this e-mail or any part thereof. Please notify the sender immediately by replying to this e-mail and delete all copies of this e-mail and the attachments.

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

[Author]

Posts