Based on the lack of clear evidence regarding the use of hospital-laundered scrub clothes and their role in the prevention of surgical-site infections (SSIs)1, many institutions can no longer validate the need to require hospital-laundered scrub clothes.
In 1997, while reviewing our facility's policies, we found that all personnel were required to wear freshly laundered hospital scrub clothes provided by the organization. We also noted that not all hospital personnel were compliant with the policy. Many surgeons at our multihospital system traveled between campuses during the day wearing the same scrub clothes and some started the day wearing scrubs from home.
It was also noted that perioperative staff occasionally washed their scrub clothes at home and kept a supply in their lockers to ensure an adequate supply.
If donning freshly laundered hospital scrub clothes in the surgical department was such a deterrent of SSIs, why was our current infection rate below national norms? Although no scientific data or research uncovered a link between home-laundered scrub clothes and SSIs,2 research did indicate that proper hand-washing technique had the most impact on cross-contamination and SSIs.3,4
Putting theory to the test
A research project was implemented in April 1998 and concluded in March 1999. The epidemiology SSI results reported no statistical difference in SSI rates between preimplementation and postimplementation of home-laundered scrubs at two of our campuses where the study was conducted. At the conclusion of this study, team members from the OR completed a questionnaire that indicated no increase or concern with family health issues related to the laundering of scrubs at home.
Since the conclusion of this study in March 1999, the practice of home-laundered scrubs has remained, and has expanded to all of our facilities. Based on epidemiology SSI surveillance reports, we continue to achieve SSI rates that are below national norms.
Implementing change
Any institution interested in implementing a home-laundered scrubs policy should consider the following:
* Visibly contaminated scrub clothes shouldn't be home-laundered.
* Establish a workable laundering exchange policy for the safety of team members.
* Because home-laundering visibly soiled scrubs is not recommended, an institution with frequent strike-through problems should reevaluate their personal protective equipment to ensure that a team member isn't frequently at risk for exposure.
* Consider using the Association of periOperative Registered Nurses (AORN) recommendations for home -laundering scrub clothes.
Our employees may transport their scrub clothes to the hospital or wear them to work. It's implied that all due care will be made not to expose ourselves or scrub clothes to harmful contaminates outside the OR. This is also expected of surgeons wearing their scrub clothes from home and between campuses. OR
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