clean hospitals
Posted By: Shirley Schmidt 
Date Posted: May 26th, 2010 Category: Being a Caregiver
Many years ago, you could tell who was a nurse and who was there to clean your room. Now you cannot tell the difference. When I am out shopping, I see hospital workers, all sorts, out shopping in their uniforms. My opinion is whereever they go and whatever they do from the time they get dressed until the time they go to work, their clothes are collecting germs, germs from their sick children, handling dirty money, touching dirty things in general, then they go to work and their clothes come in contact with me, the patient. This transfers the germs from wherever they have been to me! Beds were changed every single day, now you have to ask, doesn’t matter if there is food, blood, feces or whatever, beds are only changed when the patient ask. Sponge baths were the norm, now your on your own, get the water and items you need when and if you can. Room were thoroughly cleaned every day, now only the trash is pulled and then not always. Floors were mopped every day. I have checked into rooms with dried blood still on the floor and dirty cotton balls stuck to the bed! These are cost cutting procedures but they are causing staff infections to grow and spread at an alarming rate. 30 years ago, staff infections were far and few between. Staff changed their clothes at work, they wore clean clothes, white so you could tell if they were truly clean or not. Rooms were sanitized every single day, patients were given sponge baths or at least given the items to cleanse themselves, beds were changed everyday, we didn’t have to lay in dirty, wrinkled, bloody or smelly sheets. If you truly care about patient care, stop with the cost cutting and return to patient care.
Comment By: Craig Stevens
Date & Time: May 26, 2010 at 1:46 pm
Amen to Shirley!
Comment By: Jason Vander Weele
Date & Time: May 27, 2010 at 12:49 pm
Shirley,
I agree with you. I never have fully understood the whole "scrubs system". In old photographs it seems as though medical professionals all wore the same clothing. Today, I imagine in an effort to allow for personal expression, scrubs come in all colors and patterns, as though the fashion is important. As a patient, my caregiver's fashion is of no consequence to my health, but germs on those clothes do make a difference.
Here is a personal injury lawyer talking about these sorts of things: http://www.chicago-personal-injury-lawyer-blog.com/2008/09/doctors_spread_infection_throu.html
In the blog he says, "The idea of clothes as a means of transferring infections is a fairly new concept". Really? Ever since I was a kid I have assumed many germs were on my clothing, which is why I wash my clothes in the first place. Why else would someone be washing their clothes other than to kill all the germs and bacteria? What better place for diseases to hide than between fibers.
Comment By: Rebekah
Date & Time: May 28, 2010 at 3:22 pm
About those scrubs…
I can't speak for all areas of the hospitals and their dress codes, but in the operating rooms we adhere to the standards set by AORN, which is the Association of perOperative Registered Nurses. They not only specifically include information about wearing clean scrubs into clean areas, but even HOW those scrubs should be cleaned. There is literature out there on what kind of soap should be used, what water temperatures must be reached, everything.
Our dress code states that any staff going into the operating rooms or other clean areas (like where we sterilize instruments) at Barnes-Jewish Hospital have to get fresh scrubs that day from a machine in the locker room. The machines are stocked with scrubs that have been cleaned according to the literature standards. We are not supposed to wear them out of the hospital or even take them home to wash, according to policy.
Comment By: Nancy Gemeinhart
Date & Time: July 8, 2010 at 11:18 am
Uniforms worn by health care workers definitely have changed since the days of the traditional white uniform. Today's colorful scrubs reflect personal styles and can be used to identify various departments by color. Historically it has only been in sterile areas such as the operating room where workers were provided scrubs and actually changed into the scrubs at work.
While there is ongoing scientific research in this area, to date, there have been no indications in the literature that scrub apparel worn outside of the hospital has been responsible for the transmission of infections of any kind. And, there is no scientific evidence to suggest that home laundering versus institutional laundering poses any increased risk of infection transmission.
The room conditions you describe are not acceptable and, if something like that occurs, it should be reported immediately to the charge nurse for attention. Hospital room cleaning policies are based on guidelines from the Centers for Disease Control and Prevention. This includes mopping the floor, cleaning the bathroom and removing the trash daily. In addition, it is common nursing practice to change the sheets at least daily or if the bed becomes soiled in between the daily bed change. Once a patient is discharged, the room is given a more detailed cleaning that includes cleaning the bed. All cleaning products consist of a hospital-grade disinfectant.
At BJC, we employ a number of standards, practices and ongoing surveillance to control infection risk and protect patients.
Comment By: Jason Vander Weele
Date & Time: July 8, 2010 at 12:16 pm
I'm not quite sure that no scientific evidence exists regarding the scrubs outside of work issue.
I also tend to agree that "Experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs." as quoted from: http://www.nytimes.com/2008/09/23/health/23well.html
While an opinion piece, the following article does cite St. Mary's Health Center in St. Louis as reducing infection by laundering in the hospital: http://online.wsj.com/article/SB123137245971962641.html It also goes into many other details regarding scrubs.
Since the article mentioned it, I am curious as to what BJC is doing to prevent Clostridium difficile infections, too.
In general I'm sure BJC does a fine job about keeping things clean. I guess I tend to look toward where it might improve practices to set the standard for other organizations vs. follow the standard.
Comment By: Rebekah
Date & Time: July 8, 2010 at 12:27 pm
Just to clarify, when I was referring to "the literature" I did mean the information specifically relevant to attire in semirestricted and restricted areas in the surgical areas.
However, The AORN Perioperative Recommended Standards and Practices (2010) cites articles from Alexander's Care of the Patient in Surgery, Infection Control and Hospital Epidemiology, and the American Journal of Infection Control in its recommendations for surgical attire, specifically regarding home laundering and wearing scrubs outside of the facility.
So yes, studies have been done, and those studies are the basis for AORN's recommendations in perioperative services. While the results of these studies may not be fully conclusive, they're enough to make us careful about the way we address our dress code for surgical attire. Better safe than sorry!
Comment By: Jason Vander Weele
Date & Time: July 8, 2010 at 1:24 pm
Rebekah – I understand there is a different set of rules for surgery-related operations. When I talk about this issue, my concerns are related to all services, including staff who may or may not have direct contact with patients.
I'll stand by my statement that we could "make medicine better" by changing the ways this is done. I looked at http://www.dhss.mo.gov/HAI and it doesn't read all "zeros" for hospitals in Missouri…this tells me there is room for improvement in infection prevention, even if official studies haven't proven specifically that scrubs are the issue. I'd like to see BJC perform a conclusive study on the issue and publish it, or at least do a trial at one hospital of not having people wear scrubs outside, and see if the infection rate significantly decreases.