Sources

The following information references peer reviewed journal publications and clinical governing body statements to highlight the potential patient safety risks associated with contaminated surgical attire and unnecessary OR traffic.

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SSIs Linked to Home Laundered Scrubs

An investigative study published by Infection Control & Hospital Epidemiology, December 2012, Vol.33, No.12  revealed a nurse anesthetist’s scrubs infected with Gordonia bronchialis was the cause of multiple deep sternal SSIs during open heart surgery. The source of contamination was found to be the nurse’s front loading clothes washer, which supports the AORN’s 2012 guidelines which discourages the use of home laundered scrubs.

This investigative case validates that contaminated surgical scrubs can be the direct link to infection transmission in an SSI, even if the wearer has no direct contact with the sterile field or the site of infection itself.


 

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Scrubs Carry Pathogens

Most professionals may be diligent about washing their hands, but often overlook that their scrubs may be carrying, and potentially aiding in the transfer of resilient and deadly pathogens to both the public and their loved ones at home. Multiple studies have confirmed the contamination of healthcare workers’ surgical scrubs. A study in the American Journal of Infection Control by the University of Arizona found that 79% of the unwashed operating room scrubs tested were positive for gram positive cocci. A similar finding from an international study at Southmead Hospital (Bristol, UK) and published in the Journal of Hospital Infection found 54% of sampled scrubs were contaminated with C-Diff, MRSA, and/or VRE.

What enhances the concern for contaminated scrubs is the life span of these dangerous pathogens. A study at the University of Cincinnati and published in the Journal of Clinical Microbiology, concluded both MRSA and VRE isolates can survive for up to 90 days on hospital fabrics such as surgical scrubs, lab coats and privacy drapes.

The resilience of these dangerous pathogens is why home laundered scrubs are under scrutiny. The two studies referenced above also tested nurses’ scrubs prior to the start of their day. The University of Arizona study found that 44% of the home laundered scrubs sampled were contaminated with gram positive cocci, and the Southmead study found that 39% tested positive for C-Diff, MRSA, and/or VRE.


 

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OR Traffic & Infections

Operating Room traffic has become a key area of concern within hospital infection prevention initiatives. In a study conducted by Amphia Hospital in Brenda, Netherlands, reducing O.R traffic was considered one of four essential elements in a “bundle of care” initiative to help lower SSIs. Door openings were used as the measurement to quantify O.R traffic. After two years, compliance of the bundle reached 90%, and SSIs decreased by 50%.

According to a study published in Interactive Cardiovascular and Thoracic Surgery, increases in surgical suite traffic has a positive correlation to infection rates, as well as surgical mistakes. These monitoring initiatives draw focus on who is opening the door, and for what justification. In a study published by Clinical Orthopaedics and Related Research, it was discovered that medical device vendors accounted for 20% of all door openings second only to the circulating nurses.

These studies highlight the importance of enhancing visibility and reducing vendor traffic to restricted areas.