長袖短袖都一樣!!
Newly Cleaned Physician Uniforms and Infrequently Washed White Coats Have Similar Rates of Bacterial Contamination After an 8-hour Workday
A Randomized Controlled Trial
Marisha Burden, MD; Lilia Cervantes, MD; Diane Weed, MA, MT (ASCP); Angela Keniston, MSPH; Connie S. Price; Richard K. Albert, MD
Posted: 06/22/2011; Journal of Hospital Medicine. 2011;6(4):177-182. © 2011 John Wiley & Sons, Inc.
Abstract and Introduction
Abstract
Background: Governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease nosocomial transmission of bacteria.
Objective: Our aim was to compare the degree of bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms after an 8-hour workday and to determine the rate at which bacterial contamination of the uniform ensued.
Design: The design was a prospective, randomized controlled trial.
Setting: The setting was a university-affiliated public safety-net hospital.
Participants: One hundred residents and hospitalists on an internal medicine service participated.
Intervention: Subjects wore either a physician's white coat or a newly laundered short-sleeved uniform.
Measurements: Bacterial colony count and the frequency with which methicillin-resistant Staphylococcus aureus was cultured from both garments over time were measured.
Results: No statistically significant differences were found in bacterial or methicillin-resistant Staphylococcus aureus contamination of physicians' white coats compared with newly laundered short-sleeved uniforms or in contamination of the skin at the wrists of physicians wearing either garment. Colony counts of newly laundered uniforms were essentially zero, but after 3 hours of wear they were nearly 50% of those counted at 8 hours.
Conclusions: Bacterial contamination occurs within hours after donning newly laundered short-sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long-sleeved white coats for short-sleeved uniforms that are changed on a daily basis.
Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.
Introduction
In September 2007, the British Department of Health developed guidelines for health care workers regarding uniforms and work wear that banned the traditional white coat and other long-sleeved garments in an attempt to decrease nosocomial bacterial transmission.[1] Similar policies have recently been adopted in Scotland.[2] Interestingly, the National Health Service report acknowledged that evidence was lacking that would support that white coats and long-sleeved garments caused nosocomial infection.[1,3] Although many studies have documented that health care work clothes are contaminated with bacteria, including methicillin-resistant Staphylococcal aureus (MRSA) and other pathogenic species,[4–13] none have determined whether avoiding white coats and switching to short-sleeved garments decreases bacterial contamination.
We performed a prospective, randomized, controlled trial designed to compare the extent of bacterial contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms. Our hypotheses were that infrequently cleaned white coats would have greater bacterial contamination than uniforms, that the extent of contamination would be inversely related to the frequency with which the coats were washed, and that the increased contamination of the cuffs of the white coats would result in increased contamination of the skin of the wrists. Our results led us also to assess the rate at which bacterial contamination of short-sleeved uniforms occurs during the workday.
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