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Our Readers Come Clean on Home-laundered Scrubs
Is home-laundering scrubs an easy place to save money without jeopardizing patient or staff safety?
Dan O'Connor
Publish Date: March 17, 2008   |  Tags:   Infection Prevention

If the staff at the Surgery Center of Kansas had its way, the Wichita facility would buy its scrubs and let the staff launder them at home. "But our physicians wouldn't do this, so we'd still have to send out their scrubs, as well as the anesthesia providers' and vendors'," says Karen Gabbert, RN, BSN, the ASC's clinical director.

So, like nearly two-thirds (63.6 percent) of the 67 facility managers we surveyed on this touchy topic last month, Ms. Gabbert sends her scrubs out to be laundered. Yet our survey shows that a growing number of facilities are doing so begrudgingly, saying staff would welcome the opportunity to home-launder, if not for some resistance.

"For convenience, care and to maintain the condition of the scrubs, most staff would be willing to launder their own scrubs," says Francine Daley, RN, CNOR, administrative director of the AtlantiCare Surgery Center in Egg Harbor Township, N.J. "But AORN guidelines do not recommend home laundering, so we send them out to be laundered. Hopefully, this practice will change in the future."

Mostly it's the fear of infection, a fear many say is unfounded. The science is slim when it comes to showing that home-laundering scrubs increases infection rates. Interestingly, our readers were sharply divided over the topic (see "Home-laundered Scrubs Survey Results").

"I am absolutely certain that laundering scrubs at home will not increase your infection rates," says Jan McCoy, MSN, RN, CNAA, BC, vice president of patient care services at Health First's Cape Canaveral Hospital, where OR nurses have home-laundered their scrubs for six years. "This is a non-issue. No studies have shown any correlation between infection and laundering scrubs at home as opposed to hospital-laundering. We did an extensive literature search to see if there were any studies that showed any problems. There were zero. None."

A 2004 pilot study conducted by Priscilla Jurkovich, MSN, RN, found that unprotected scrub attire worn outside the OR wasn't significantly more contaminated than scrub suits that weren't worn outside the OR. In 1997, researchers concluded that home-laundered scrub clothing could be worn safely in labor and delivery units, including ORs contained in those units. Another study concluded that low-temperature washing was as effective as high-temperature washing in eliminating bacteria from hospital laundry.

Not in my Maytag
Despite those findings, several of the mangers who responded to our survey believe that wearing home-laundered scrubs into the OR could increase the risk of surgical infections while also posing a reverse risk to nurses, who might take a hospital-acquired infection home with them.

"Staff are glad they don't have to take dirty scrubs home and wash them in the family machine," says Corinne Casey-Lyons, RN, director of perioperative services at Eden Medical Center in Castro Valley, Calif.

Some feel it is inappropriate to launder scrubs in a home setting. "Staff don't want to take scrubs that have blood and other bodily fluids on them home to be laundered in their family washing machines," says the nurse administrator at an ENT surgery center. "Scrubs laundered for the OR must be laundered at a specific temperature and with specific anti-bacterial detergents. The usage of scrubs in operating rooms has always been to protect the surgical patient from bacteria carried into the OR from outside clothing. When scrubs are home-laundered, there is no protection for the patient from outside."

"Most of the staff enjoy the convenience of having the scrubs laundered for them. They don't like the concept of having work clothes worn in the OR in with their personal items," says Gwen Grothouse, RN, administrative director of the Apple Hill Surgical Center in York, Pa.

Maggie Johnson, RN, CNOR, CASC, director of the Center for Outpatient Surgery in Sartell, Minn., says her staff would love to be able to at least have home-laundered hats for fun and personal expression, but AORN doesn't support this practice. "It would be difficult to know if any scrub item is truly being laundered and transported so it's protected from contamination," she says.

Celia Larimore, CNOR, MSN, director of surgical services at Morton Plant Mease Health Care in Safety Harbor, Fla., considers home-laundered scrubs to be one of infection control's many sacred cows. "After much research and our own trial on the subject, we implemented home-laundered scrubs in 1997," she says. "It was initially difficult, but ultimately successful."

Home-laundered Scrubs Survey Results

At my facility, ___________

Staff are responsible for purchasing and laundering their own scrubs at home.

12.1%

Staff are responsible for laundering the scrubs our facility buys for them.

19.7%

We send scrubs out to be laundered.

63.6%

We launder scrubs in-house.

4.5%

In the current environment of cost containment, home-laundering scrubs is an easy place to save money without jeopardizing patient or staff safety.

I strongly agree

17.9%

I agree

20.9%

Not sure

25.4%

I disagree

19.4%

I strongly disagree

16.4%

Have you noticed any increase in surgical infection rates since you began your home-laundered scrub policy?

Yes, infections have increased.

0.0%

No, there's been no difference.

48.2%

I'm not sure.

1.8%

Not applicable

50.0%

SOURCE: Outpatient Surgery Magazine Reader Survey, February 2007, n=67

In favor of home-laundered scrubs
Nearly one-third (31.8 percent) of the 67 facility managers we surveyed make their staff responsible for washing their scrubs at home — 12.1 percent make staff responsible for purchasing and laundering their own scrubs at home and 19.7 percent make staff responsible for laundering the scrubs their facility buys for them.

"Staff seem to prefer it. We have an in-house laundry (as do 4.5 percent of respondents to Outpatient Surgery's survey), but most staff take their scrubs home to launder. It's their option," says Allison Maestri, RN, director of the Surgery Suite in Slidell, La.

For staff, the benefits of home-laundering include convenience, individual expression and scrubs that fit well.

"In addition to enjoying the diversity of the scrubs they wear, they like not having to change clothes at the facility." says one respondent. "Our infection rate is very low and we have not seen any increase in the rate."

"No one has opposed the idea of home-laundered scrubs. They enjoy the creativity of buying and wearing their own scrubs to fit the patients and the events of the day. Patients seem to enjoy the variety as well," says Tricia Strauss, RN, BSN, CNOR, director of the San Marcos (Texas) Surgery Center.

A reversal
An interesting thing happened when staff at Doctors Hospital-Ohio Health in Columbus, Ohio, were given the option of laundering scrubs at home or using hospital-supplied scrubs. At first, most eagerly opted for home-laundered scrubs, says Mary Ann Cain, RN, BSN, MSA, director of perioperative services. "But as time went on, there's been less interest to do so, mainly for the inconvenience of transporting scrubs back and forth. Now we have very few staff who wash scrubs at home," she says.

What Your Colleagues Say About Home-laundered Scrubs

  • "Due to the complexity of the procedures that we do and the potential for contamination, staff prefer not to take their scrubs home for laundry. We're also not to wear scrubs that are worn in the surgical suite to and from work."
  • "I think if we tried to home-launder scrubs, there would be opposition. Our infection control people would not support this change."
  • "Staff refuse to do it."
  • "The scrubs from the linen service were less than desirable in fit and performance and after continued staff dissatisfaction, the staff voted for the opportunity to purchase and maintain their own scrubs. Should they find themselves in need of fresh scrubs during their shift, the center has scrubs from the linen service still available. The linen service scrubs are primarily utilized by the physician and anesthesia staffs and by housekeeping."
  • "Policy dictates scrubs for restricted areas are the responsibility of the hospital."
  • "Staff prefer that scrubs are clean and on the shelf ready for them to wear. They do not want to wear or take home dirty scrubs from their day of patient care."
  • "In an ongoing effort to save the employees money in not having to purchase their own uniforms, they feel that it is fair for them to launder them. In fact, they are more comfortable knowing the type of detergent that is being used, and the conditions under which the scrubs are being laundered."
  • "Our staff would like to be able to wear their own personal hats and warm-up jackets, which would have to be laundered at home. Presently we are allowing home-laundered hats in the OR but no other home-laundered garment."
  • "Staff prefer to have their scrubs laundered for them, for the most part. Some staff do wear home-laundered as our policy allows for both. Since AORN still does not recommend home-laundered, we have never taken the next step by making it mandatory."

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