The following article is written by Charles Kinder, MD, director of heart rhythm program for Heart Care Centers of Illinois and founder of DocFroc.
Sixteen million healthcare professionals wear scrubs in the workplace everyday. A recent study released by the Department of Microbiology and Immunology at the University of Arizona revealed the following findings:
- 92 percent of scrubs worn by hospital personnel are carrying dangerous bacteria including MRSA, VRE and C-Diff by the end of every work shift.
- 79 percent of unwashed operating room scrub swatches were contaminated with some type of Gram-positive cocci.
- 69 percent tested positive for coliform bacteria, three of which were E. coli.
These large numbers of bacteria are of concern as most people don't realize they are giving germs a free ride and dragging them around from patient to patient. Healthcare professionals may be diligent about washing their hands at work, but it's often overlooked that their uniforms can potentially aid in the transfer of deadly bacteria. Healthcare worker uniforms routinely come into contact with patients during normal examination and care procedures. Surgeons perform several operations every day. In between cases, these doctors make rounds in the ICU and see new consultations in the emergency room and many of these patients have infections. In changing wound bandages and in leaning over patients to listen to their heart or lungs, doctors scrubs inevitably come in contact with bacteria.
Dangers and costs of hospital-acquired infections
Hospital-acquired infections (HAIs) are a major source of accidental fatalities in the United States, claiming the lives of 99,000 patients every year according to the Centers for Disease Control and Prevention (CDC). The threat is significant, as the CDC also reports there are approximately two million HAIs each year.
I believe that physicians, nurses, hospital administrators and hospital employees are obligated to do everything possible to address the accidental infection problem. I lost a patient who came in the hospital for elective surgery and that patient died from an infection acquired during this patient's hospital stay. Prior to this patient's preventable and tragic death, I had no idea that garments could transmit bacteria from patient to patient. I then discovered that the American Medical Association had considered banning the doctors' lab coat due to the overwhelming evidence that bacteria can hitch a ride on lab coats and scrubs.
HAIs can be deadly and are always costly. Patients that suffer from an HAI often require additional surgical procedures, a prolonged hospital stay and lengthy intravenous antibiotic therapy. Average total treatment cost is $30,000. Since many of these infections are preventable, Medicare has recently decided that it will not reimburse the hospital for the cost of treatment. Currently, Medicare will not reimburse for the cost of treating HAI related to open heart and obesity (bariatric) surgery. With increasing budget pressure, this list of non-covered conditions will surely grow. It is in everyone's best interest — patient, doctor, nurse and hospital administrator — to prevent these infections from occurring.
Need for antibacterial clothing
It's important to recognize that MRSA can survive a long time on clothing; anywhere between a few days to up to three weeks. Antimicrobial technology is now starting to emerge in healthcare uniforms and can offer an easy and cost-effective path to improved technology. According to Dr. Charles P. Gerba, professor of Environmental Microbiology at the University of Arizona and author of the scrubs study, Tri-Active, a silver-based antimicrobial compound, has been studied for many years and can kill MRSA and many viruses at the point of contact.
During surgery the technical outcome is almost always achieved. However, patients have complications related to other aspects of their care especially post-operative infections. As a doctor my pledge is to "do no harm" as I try to improve and extend my patients' lives. Wearing an antibacterial lab coat and scrubs is the ultimate way for me to show my patients that I care. Given the overwhelming evidence that garments can transmit bacteria, I would expect patients and payors to favor a medical team and hospital that encourage the use of antibacterial garments.
Dr. Charles Kinder is founder of DocFroc, a joint venture with Blue Devil Textile aimed at addressing the hazards of lab coats and scrubs contributing to the cause of hospital-acquired infections directly. For more information on DocFroc, visit www.docfroc.com.
