New research shows hospital scrubs can easily be contaminated with bacteria even when nurses wear clothing made with antibacterial fabric.
Researchers from Duke University Hospital tested whether the antimicrobial scrubs were effective in preventing bacteria contamination on 40 nurses who worked in medical and surgical intensive care units caring for one to two patients per shift at the 936-bed tertiary-care hospital. The nurses wore three different types of scrubs over three consecutive 12-hour shifts and researchers took a series of cultures from each nurse’s clothing, patients and the environment before and after each shift.
Nurses didn’t know whether they were wearing scrubs made with traditional cotton-polyester, clothing that contained silver-alloy embedded in its fibers or surgical scrubs treated with a combination of antibacterial materials. The research team analyzed more than 2,900 cultures from bed rails, beds and supply carts in each room and 2,185 cultures from the sleeve, abdomen and pocket of nurses’ scrubs. They found no differences in contamination based on the type of scrubs worn by the nurses.
Researchers identified new contamination in 33% of the shifts. Scrubs were newly contaminated with bacteria during 16% of the shifts studied. Three of those cases occurred while nurses cared for patients who were on contact precautions because they were infected with drug-resistant bacteria and personnel entering the room were required to put on gloves and gowns. The most commonly transmitted bacteria was Staphylococcus aureus, including MRSA and methicillin susceptible S. aureus.
The findings were published this week in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
Study authors said the scrubs were likely ineffective at reducing bacteria because of the low-level disinfectant capabilities of the textiles coupled with repeated exposure in a short time frame. They suggest antimicrobial-impregnated textiles might be effective if used in bed linens and patient gowns, given the prolonged exposure to patients.
“Healthcare providers must understand that they can become contaminated by their patients and the environment near patients,” lead author Deverick J. Anderson, M.D., director of the Center for Antimicrobial Stewardship and Infection Prevention at Duke University Medical Center, said in a study announcement. “Although not effective, we looked to eliminate this risk for contamination by changing the material of nurses’ scrubs.”
Furthermore, he noted, bacteria and pathogens will always be in the hospital environment. Therefore, he said, hospitals must create and use protocols to improve cleaning of the healthcare environment, and patients and family members must feel comfortable asking healthcare providers if they are doing everything they can to keep their loved one from being exposed to bacteria in the environment.
The researchers also recommend that nurses follow diligent hand-hygiene practices when they enter and exit all patient rooms. When appropriate, they should also wear gowns and gloves, even if they don’t plan to perform direct patient care. This will help reduce the risk of clothing contamination of healthcare providers.